c-zsqe.c ' 



INTRODUCTORY LECTURES 



AND 



ADDRESSES, 



ON 



MEDICAL SUBJECTS, 



DELIVERED 



CHIEFLY BEFORE THE MEDICAL CLASSES 



OF THE 



UNIVERSITY OF PENNSYLVANIA, 

GEORGE B. WOOD, M.D., LL.D.^^'qjo^J 

PRESIDENT OF THE AMERICAN PHILOSOPHICAL SOCIETY ; PRESIDENT OF THE COLLEGE OF PHYSICIANS 

OF PHILADELPHIA ; EMERITUS PROFESSOR OF THE THEORY AND PRACTICE OF MEDICINE, 

AND OF CLINICAL MEDICINE, IN THE UNIVERSITY OF PENNSYLVANIA, ETC. 



SECOND EDITION. 



PHILADELPHIA: 

J. B. LIPPINCOTT & CO. 

18 7 2. 









Entered, according to Act of Congress, in the year 1S72, by 

GEORGE B. WOOD, M.D., 

In the Office of the Librarian of Congress at Washington. 



TO THE 

MEDICAL G-E/ADUATES 
OF THE 

UNIVERSITY OF PENNSYLVANIA, 

FROM THE SPRING OF 1836 TO TEIAT OF 1860, 

INCLUSIVE, 

BEFORE WHOM WERE DELIVERED, 

AND IN WHOSE BEHALF WERE PREPARED, 

MOST OF THE FOLLOWING DISCOURSES, 

THIS VOLUME 

IS INSCRIBED, AS A MEMORIAL 

OF THE MANY AGREEABLE, 

AND, MAY I NOT SAY, PROFITABLE HOURS, 

THEY AND I HAVE SPENT TOGETHER, 

AND OF THE AFFECTIONATE INTEREST WITH WHICH I CONTINUE, 

AND, SO LONG AS LIFE MAY LAST, 

SHALL EVER CONTINUE TO REGARD THEM. 

GEO. B. "WOOD. 



PREFACE. 



Being about to withdraw from scholastic medical teaching, the author 
conceives that this may be a proper occasion for publishing, in a con- 
nected form, the introductory lectures and addresses, relating to medi- 
cine, which he has at various times delivered. Most of them have been 
already printed separately by the several classes or societies before 
whom they were respectively read ; but some of them now appear in 
print for the first time. Kepresenting, as they do, the views and senti- 
ments of one long devoted to the medical profession, and compelled, by 
the necessities of his position, to observe, investigate, and reflect upon 
the concerns of that profession in all its different relations, scientific, 
practical, ethical, and historical, they can scarcely fail to contain 
lessons, which may be more or less useful to the student and young 
practitioner. This consideration may, perhaps, be received as a suffi- 
cient excuse for their publication ; but the author confesses that he has 
also other viev^s. He wishes to bring himself again to the memory of 
the many physicians, some of them now no longer young, who have 
listened to his instructions during their years of pupilage, and to leave 
with them a memento, by which, when he shall be no more personally 
among them, they may now and then recall him to mind, with kindly 
recollections of former intercourse. 

Though the subjects are in a greater or less degree discursive, yet 
the discourses are so related among themselves, that they may be 
divided into groups, each having a certain unity of character or pur- 

(O 



VI PREFACE. 

pose ; and the reader will notice that they have been thus arranged in 
the followiog collection. The author has occasionally added foot-notes, 
when the lapse of years since their delivery has been attended with 
changes, which render the statements in the text not applicable to the 
present time, and when misapprehensions might occur without such a 
precaution. He has only further to observe that all the discourses have 
a medical bearing, that most of them were delivered to audiences exclu- 
sively medical, and that, consequently, they are especially addressed to 
the sympathies and wants of his own profession. In this light he wishes 
them to be viewed ; and. should others than those for whom they are 
intended happen to glance over them, he hopes they may bear in mind 
that objects look very differently according to the medium through 
which they are seen, and thus be disposed, if the tints be not always 
such as are most natural and agreeable to their eyes, to ascribe the 
result, in some measure at least, to this cause. Of the friendly dispo- 
sitions of his professional brethren he has received too many proofs, to 
allow him to have any misgivings on this score ; and he, therefore, trusts 
the book to the tribunal of their opinion, with every confidence that it 
will be kindly judged. 

Philadelphia, December 21st, 1S59. 



TABLE OF CONTENTS. 



I. — Pharmaceutical Addresses. 

1. Address to the Members of the Philadelphia College of 

Pharmacy. 

2. Address to the Graduating Class of the Philadelphia College 

of Pharmacy. 

II. — Lectures Introductory to the Course on Materia Medica and Phar- 
macy in the University of Pennsylvania. 

1. History of Materia Medica. 

2. History of Materia Medica in the United States. 

3. Importance of Materia Medica. 

4. Abuses to which the Materia Medica is liable. 

5. Mental Agency in the Treatment of Disease. 

6. On the Choice of Medicines. 

III. — Lectures Introductory to the Course on the Theory and Practice of 
Medicine in the University of Pennsylvania. 

1. The Theory and Practice of Medicine. 

2. Kequisites in the Study of Medicine. 

3. Character and Objects of the Medical Profession. 

4. Scope of the Practice of Medicine. 

IV. — Introductory Lectures giving the Eesults of Professional Observa- 
tion Abroad. 
1. The Medical Profession in Great Britain. 
2 The Medical Profession on the Continent of Europe. 

(vii) 



Till TABLE OF CONTENTS. 

Y. — Addresses to the Medical Graduates of the University of Pennsyl- 
vania. 

1. Sketch of the History of the Medical Department of the Uni- 

versity of Pennsylvania. 

2. Address to the Graduating Class of April, 1841. 

3. Address to the Graduating Class of April, 1856. 

YI. — Biographical Memoirs. 

1. A Memoir of the Life and Character of Joseph Parrish, M.D., 

read before the Medical Society of Philadelphia, October 
23rd, 1840. 

2. A Memoir of Samuel George Morton, M.D., read before the 

College of Physicians of Philadelphia, November 3rd, 1852. 



PHARMACEUTICAL ADDRESSES. 



I. 

ADDRESS TO THE 

MEMBERS OF THE COLLEGE OF PHARMACY. 

DELIVERED NOVEMBER 16th, 1824. 



Prefatory Remarks. 

The following address was delivered in the interests of the Philadel- 
phia College of Pharmacy, then a very young institution, and standing 
much in need of support. The College was founded in 1821, and imme- 
diately established a school, in which lectures were delivered on chem- 
istry and materia medica during the winter. In the following year it 
was incorporated ; and the Trustees did me the honour to elect me to 
the professorship of chemistry, on which subject I had previously been 
lecturing to a class of medical students. The institution languished at 
first ; and it was in order to excite attention to its importance, and rouse 
the zeal of the druggists and pharmaceutists of the city in its favour, 
that this address was prepared. It has been among the highest gratifi- 
cations of my life, that I was able to contribute towards the expansion 
and permanent success of a school, which has been productive of much 
good, which is still in prosperous operation, and the establishment of 
which may be considered as the commencement of a new era in the phar- 
macy of the United States. 

' (3) 



THE ADDRESS. 

Gentlemen of the College: — 

It may appear singular that an individual, not immediately 
connected with your profession, should so far interest himself 
in its concerns, as to request your attention to a discourse, the 
chief object of which is the promotion of your welfare. To escape 
the charge of officiousness, which might, with apparent pro- 
priety, be brought against me, it becomes necessary to preface 
the observations I wish to offer, by a statement of my motives 
for offering them. 

The professions of medicine and pharmacy, though, in prac- 
tice, they should always, if possible, be entirely distinct, have 
nevertheless a mutual dependence so complete, that the excel- 
lence and usefulness of the one are materially affected by any 
deficiency in the other. Physicians, however versed in the 
nature of disease and skilful in its management, will inevitablv 
meet with failures and disappointments, if supplied by the 
apothecary with inefficient medicines. As a medical practi- 
tioner, therefore, I cannot but feel a strong interest in the pro- 
fession to which you are attached, and am bound to contribute, 
as much as lies within my power, to its improvement in re- 
sources, and advancement in respectability; for in proportion to 
the real standing of an apothecary in knowledge and character, 
will be the confidence with which we can rely on the efficacy of 
his preparations. 

Still it may'be said, that any interference in your affairs would 
have come with better grace, and much stronger probability of 
success, from some other physician, whose more advanced age, 

(4) 



PHARMACEUTICAL ADDRESSES. 5 

and better established character, might give him a more in- 
disputable claim to your attention. But, waving the considera- 
tion that no one, with such qualifications, has yet come forward 
so decidedly, I may perhaps be allowed to urge, as an excuse 
for the course I have adopted, the situation to which the partial 
suffrages of no inconsiderable number of your body have ap- 
pointed me, in the institution within whose walls I now address 
you As one of the teachers in the College of Pharmacy, anx- 
ious for its prosperity, because regarding it as the source of 
great advantages to both professions, and to the community in 
general, I feel confident that you will not attribute my present 
proceeding to improper motives; either to a meddling disposi- 
tion, or a vain love of display. 

Before entering on the main subject of the discourse, it may 
not be improper, in a few words, to indicate the standard, both 
of attainment and character, at which every apothecary should 
aim. That he should have received a good general education, 
is necessarily implied in his acknowledged title to the rank of a 
gentleman. An acquaintance, to a certain extent, with the Latin 
language is indispensable ; for, without it, he would be utterly 
at a loss to understand the simplest medical prescription, and 
might often commit mistakes, the consequences of which might 
be irremediable, as regards both the health of the patient and 
his own reputation. Equally essential is an accurate knowledge 
of the two extensive sciences of chemistry and materia medica. 
Whether in the preparation of his own medicines, or in the 
formation of a correct judgment relative to the strength and 
purity of those he procures from others, the assistance which 
these sciences afford is of the greatest importance ; for the prin- 
ciples of the one are intimately concerned in every pharmaceuti- 
cal operation, and an account of the sensible properties of drugs, 
with their effects upon the system, constitutes the very essence 
of the other. Botany and mineralogy, though of less importance, 



6 PHARMACEUTICAL ADDRESSES. 

will, however, serve to enlarge his fund of useful knowledge, 
and procure him a profitable reputation ; while, by the facility 
they give to his researches in the two great kingdoms of vege- 
table and mineral nature, they will be found highly serviceable 
in his professional pursuits. 

But the possession of this knowledge is by no means sufficient. 
The apothecary is eminently a practical man. Having accumu- 
lated a sufficient store of science, he must familiarize himself 
with the various modes of applying it. To become perfectly 
acquainted with all the manipulations of pharmaceutical pro- 
cesses ; to acquire that accuracy of observation which shall 
render the evidence of his senses certain, and a mistake as to 
the nature of articles submitted to his inspection next to im- 
possible; to be able, amidst the bustle of business, to dispense 
his medicines neatly, and without the least variation from the 
formula prescribed ; these attainments, which are essential to 
merited success, require a long devotion of time, and a close at- 
tention to the practical duties of his profession. They require 
that he should have served a diligent apprenticeship to his art, 
under the direction of some competent instructor, and in a situa- 
tion where opportunities for practice are constantly afforded. 

Still, however, something is wanting to the perfection of his 
character. Knowledge and practical skill must serve as the 
main spring of his actions ; but these are insufficient without 
the regulating influence of correct principles. The temptation 
to dishonest practices is strong in proportion to their apparent 
advantages, and their difficulty of detection ; and the degree 
of their criminality may be considered as commensurate with 
the evil they are calculated to produce. These conditions are 
peculiarly incident to the profession of pharmacy; for spurious 
or adulterated drugs must afford immense profit in their sale, 
and but a small proportion of purchasers are able to judge of 
their efficacy; while the injury which must result from their 



PHARMACEUTICAL ADDRESSES. 7 

employment, can be measured only by the value we attach to 
our health and our existence. Thus strongly tempted, and thus 
guilty when yielding to temptation, the apothecary is especially 
called on to cultivate his moral sense ; to cherish in his mind 
correct and virtuous sentiments ; and to watch, with peculiar care, 
that his conduct accord with the dictates of his conscience. 

Such as I have described to you is the truly accomplished 
apothecary; a man of general information, of literature, of 
science; intimately acquainted with the principles, and skilful in 
the practice of his peculiar art ; upright and honourable in his 
dealings ; a man whom all who know him must esteem, and 
who will necessarily hold a most respectable station in every 
community, where rank is at all the criterion or the reward of 
merit. As a profession is generally exalted in proportion to the 
reputation of its members, such a man will elevate with himself 
the whole body to which he belongs. How grateful to the best 
feelings of his nature, must be the consciousness of this truth ! 
how powerful and honourable the motive which it offers to 
strong and continued exertion for individual improvement ! 

But such is the constitution of human nature, that whatever, 
even with a view to our own good, calls upon us to overcome 
our habits of negligence, and natural indisposition to labour, 
unless the advantages to be derived are manifest and immediate, 
is apt to appear chimerical in our eyes, the result of wild specu- 
lation, not of sober reflection ; — or, even if the propriety of the 
call be undisputed, we are too often inclined to prefer present 
ease and gratification, to an obedience which would involve us 
in much painful exertion and self-denial. 

I am sure you would accuse me of a base attempt at adulation, 
were I to exempt the members of the pharmaceutical profession 
from this general reproach. Though the apothecaries of Phila- 
delphia have certainly outstripped those of any other part of the 
American continent in the race of improvement ; yet even here, 



8 PHARMACEUTICAL ADDRESSES. 

the most partial of us will allow, that the goal is far distant. 
Instances are not wanting of extensive general information, and 
great scientific attainment : and the reputation of the profession 
for knowledge, skill, and character is highly respectable: but a 
wider diffusion, and more accurate knowledge of those sciences 
to which I have before alluded, will be admitted to be desirable ; 
and greater skill and strictness in the practical management, by 
insuring to the purchaser the best possible preparations, and to 
the physician an exact compliance with his directions, will have 
a most beneficial influence on the general credit of the art, and 
the private advantage of its members. It becomes, therefore, a 
matter of no little importance, to discover and adopt some com- 
prehensive system, by which, at the same time, stronger motives 
and more extensive means of improvement shall be afforded to 
the student, and a controlling and regulating influence exerted 
over the whole profession. 

A strong and general sense of the usefulness, if not the neces- 
sity, of such a system, has already induced the apothecaries of 
this city, with a spirit which does them honour, to unite their 
exertions for the establishment of a college; — the first attempt of 
the kind made on this side of the Atlantic. That an institution 
of this nature, properly regulated and supported, is calculated to 
contribute greatly to the attainment of the ends proposed, will 
be admitted by all who can be induced to examine the subject 
coolly, and with candour. My principal object, in the present 
address, is to call your attention to the College already estab- 
lished. Most of you are not ignorant that it stands in need of 
assistance; and, if I should be so fortunate as to impress you 
with a conviction, that great advantages must result from its 
successful operation, and that your honour as a body would suf- 
fer by its fall, I am confident that your zealous efforts will not 
be wanting, to augment its strength, and infuse increased vigour 
into its movements. 



PHARMACEUTICAL ADDRESSES. 9 

It has long been a well-established principle, that in all at- 
tempts to ameliorate the condition, extend the information, or 
exalt the character of large bodies of men, the greatest success 
may be expected from those efforts which are directed to the 
rising generation. The habits and opinions engrafted upon us 
in early life, and at first but feebly attached, become, as we ad- 
vance in years, more and more closely united with our thoughts 
and affections, till at length they seem to form a portion of our- 
selves, and to be almost identified with our existence. They 
may indeed sometimes be torn away, as a limb may be torn from 
the body ; but the whole mental constitution will be agitated to 
the centre, and any substitute which may be supplied, will sel- 
dom be characterized by the strength and symmetry of a natural 
growth. Besides, there is, in age, a great want of spirit and 
enterprise. The mind has settled down into consistency and 
firmness ; but its elasticity is gone. New projects, even though 
their utility may be undisputed, as they require vigorous exer- 
tion, are received with coolness, and treated with neglect. 
Youth, on the contrary, while it is open to correct impressions, 
possesses also that vivacity of spirit which leads it to despise 
difficulties, and that energy of action which enables it to over- 
come them. 

In aiming, therefore, at the improvement of your profession, 
your eyes should be especially directed to those who are yet in 
their state of preparation. In a few years they will constitute 
the majority of your number, and will give the tone of their own 
character to the whole fraternity. Make them scientific, skilful, 
honest, enlightened apothecaries, and you will have done more 
than could be effected by any other means, towards the advance- 
ment of your art in respectability and importance. For the ac- 
complishment of this purpose, I know of no instrument so effectual 
as a collegiate institution, properly organized and supported. 

To give full efficiency to such an institution, two great objects 



10 PHARMACEUTICAL ADDRESSES. 

should always be held in view ; the one, to provide competent 
means of instruction, the other to offer such inducements to the 
student as shall overcome his natural love of ease, and dispose 
him to the full exertion of his faculties. 

The first of these objects is most readily attainable by the es- 
tablishment of lectureships, with the auxiliary aid of a good 
cabinet of specimens, and a well-selected library. Universal ex- 
perience has adopted the mode of instruction by lectures, as 
decidedly the most appropriate for conveying scientific informa- 
tion. The solitary student, who pursues his inquiries unassisted 
by those better informed than himself, meets with a thousand 
impediments, which, if they do not totally discourage him, will 
materially retard his progress. Almost all works of science 
contain much that is of little comparative importance, which, 
however, as the learner is unable to exercise proper discrimina- 
tion, he feels himself bound to load upon his memory, equally 
with that which is most essential. In this way much time is 
lost; and facts most deserving of remembrance, being mingled 
and diluted with trifling matters, and useless speculation, make 
a less vivid and lasting impression on the mind. There are, 
moreover, other disadvantages which attend the unassisted stu- 
dent. In the commencement of his studies, he will often en- 
counter passages that are to him totally unintelligible, because 
they suppose a degree of knowledge which he has not yet at- 
tained ; and throughout his whole course, the description of un- 
known substances, and the history of phenomena with which he 
is not familiar, as they are unaided by the evidence of his senses, 
will present to his mind inadequate or erroneous conceptions. 
A competent lecturer will have it in his power to obviate these 
difficulties. From a great mass of materials, he may select all 
such as bear most immediately on the particular subject of his 
lecture, rejecting what is of little or no interest or practical 
utility, and placing in a prominent point of view those facts most 



PHARMACEUTICAL ADDRESSES. 11 

essential to the learner. Whenever any difficulty occurs, he may 
enter into familiar explanations adapted to the capacity of the 
most uninformed of his hearers. He may draw from every 
source appropriate illustrations, and, without losing- sight of the 
main design of his course, may endeavour to attract and fix the 
attention by just and pleasing reflections, entertaining anecdotes, 
and the beauties of an easy and spirited style. In the experi- 
mental sciences, the lecturer has the additional advantage of 
illustrating facts, and enlivening their detail, by the actual ex- 
hibition of interesting phenomena, which, by placing the objects 
of his attention immediately before the senses of the learner, 
renders the impression they make both more exact and perma- 
nent. 

There can be little difficulty in deciding upon the most appro- 
priate lectureships in a school of pharmacy. Those sciences 
should be taught which I have before mentioned as either essen- 
tial or highly useful to the apothecary ; and materia medica and 
chemistry, being exceedingly copious, will each afford abundant 
occupation for the time and talents of one individual. To these 
two lectureships might be added another on botany and miner- 
alogy, which, being less important, and requiring, as regards the 
apothecary, less minuteness of detail, might readily be united 
without imposing too heavy a burden on the lecturer. 

I have mentioned, among the advantages of a collegiate estab- 
lishment, the facility which a good library and cabinet of speci- 
mens will afford to the student, in extending his knowledge, and 
forming an accurate acquaintance with the materials of his busi- 
ness. On this head I need not enlarge. Their utility is too ob- 
vious to need illustration ; and I am happy to be informed that, 
in our own College, no inconsiderable exertions have been made 
for their attainment. 

Professorships on the two most important pharmaceutical sci- 
ences have also been instituted, and regular courses of lectures 



12 PHARMACEUTICAL ADDRESSES. 

on chemistry and materia medica have been delivered for the last 
three winters. It would give me great pleasure to be able to tell 
you, that this department of the College is in an equally flourish- 
ing Condition ; but most of you are aware that such an assertion 
would be an empty boast. The fact is, that, during the last 
winter more especially, the labours of the lecturers were re- 
warded by little more than the consciousness that their own 
share of the necessary duties had not been entirely neglected. 
The slender expenses incident to the chemical course absorbed, 
within a very trifling sum, the whole receipts from the students of 
pharmacy ; and the lecturer was denied the pleasure he himself 
would have derived from the exhibition of more numerous ex- 
periments, by the apprehension of actual private loss. He might, 
indeed, be disposed to attribute this want of encouragement to 
his own imperfections as a lecturer; but surely the same reason 
could not be assigned for an almost equal desertion of his col- 
league. The lectures of the professor* of materia medica have 
never been accused of deficiency, either as to the value of the 
knowledge they inculcate, or as to the manner in which that 
knowledge is conveyed. We must, therefore, look to another 
source for at least a portion of this neglect ; and may we not 
find it in the apathy of a great majority of the members of the 
College ? Considering it a probable circumstance that this 
apathy may have arisen, in some degree, from an imperfect ap- 
preciation of the importance to an apothecary of an acquaint- 
ance with the sciences alluded to, or at least from a belief that a 
sufficient knowledge of them could readily be attained by private 
and industrious study, I attempted, early in the discourse, to im- 
press you with the conviction of their great utility, and subse- 
quently to exhibit the superior advantages of the mode of in- 



* Dr. Samuel Jackson, now Emeritus Professor of the Institutes of Med- 
icine in the University of Pennsylvania. 



PHARMACEUTICAL ADDRESSES. 13 

struction by lectures. How far the attempt has proved successful, 
you are certainly the most competent to decide. 

It may, indeed, be urged, that even allowing the great impor- 
tance to the student of the opportunities which the lectures afford 
him, still, as no immediate profit can accrue to those at present 
established in business, they cannot be expeGted to incur much ex- 
pense, either of time or money, for their maintenance. But sup- 
posing, for a moment, that this department of the College can 
be productive of advantage only to the future apothecary ; are 
there no other motives than the mere prospect of pecuniary 
profit which can excite a man to action ? Are we not under a 
strong moral obligation, to provide for those committed to our 
care the most ample means of instruction in the art we profess 
to teach them ; and are we not, in some measure, answerable for 
the evils which must result from their deficiencies ? Can we 
feel no gratification in contributing to exalt the character, and 
brighten the prospects of our younger brethren by profession ; 
and thus giving to the profession itself an increase of conse- 
quence and respectability ? When, moreover, we have intro- 
duced ourselves to the notice and applause of the world, by 
originating a project, noble in its objects, and calculated to pro- 
duce the most beneficial results, is there no disgrace in abandon- 
ing it without an effort ? in allowing it to perish from neglect in 
the very infancy of its existence ? Are not these considerations 
alone sufficient to counterbalance the pain and inconvenience of 
a little exertion, or a trifling pecuniary sacrifice ? I am confident 
that you feel them so. I am satisfied there are very few among 
you, who would not willingly contribute, to any reasonable ex- 
tent, towards the attainment of objects so praiseworthy in 
themselves, and so closely connected with your own honour. 

It may justly be expected, that, while I am thus calling for your 
active interference in support of the school you have established, 
I should also indicate the path in which your efforts may be most 



14 PR AWACBrnC AE ADDRESSES. 

successfully directed. At present, I allude only to the lectures. 
Yon will admit them to be an essential part of the institution ; 
and yon are aware that, without further support than they have 
hitherto obtained, they most either be entirely abandoned, or drag 

'.- i :::.i Ii~i"i:i iii i'^is: i-t!t-- tz:^:t:::t 1_r :;"f=:i::: 
then is, in what way can assistance be most conveniently and 

a powerful agent of improvement, cannot, in the present instance, 
be justly demanded. The profession of pharmacy, like that of 
medicine, abounds more in honour than in pro tit. I know what 
it is to feel a spirit of enterprise cramped by the narrow bounds 
of a slender income; to find all the resources which indc - 
supply, absorbed by the necessities of daily support. There are 
other methods by which the desired end may be more conveni- 
ently attained. Within the limits of Philadelphia, the number 
of young* men who annually engage as appren tc the apothe- 

cary's business is certainly sufficient, if their attendance upon the 
lectures could be secured, to afford the lecturers a compensation, 
not indeed very ample, but such as might at least prevent the 
discouraging' reflection, that their labours, as regards themselves, 
are totally fruitless. To these your efforts should be directed. 
Tour relation with them is of such a nature, that your opinions 
must be highly respected, and your advice influential. Endeavour 
to impress them with the belief, that their own reputation and 
::irr:.iT~: »^-:-:es= ~..'. :e rssentially promoted by a diligent 
cultivation of the opportunities afforded by the lectures ; repre- 
sent to them that no policy is more absurd, than, from the 
of incurring a slight expense, to build on an insecure foundation ; 
and that a small sum, appropriated to the enlargement of their 
pr::e=s::LiI ii_:~~ _-:.-r nrill —Vi in :_r :i':.:- ;::: ~ f : i:i;n ::' 
:iri: ;"i=izr=i i n:=: ?-— z\z -.it-tIt-" L:.~ '.ri::- :iirii :iif 
prospect, so attractive to the ambitious and generous spirit of 
youth, of contributing by their labour- for ^If-iniprovenien 



PHARMACEUTICAL ADDRESSES. 15 

elevate the dignity, and augment the influence of their art ; and, 
having thus addressed yourselves to their interest and honour, 
appeal also to their sense of duty, by inculcating their strong 
moral obligation to enter fully prepared upon a business, in 
which it is easy to err, but difficult and often impossible to 
retrieve the consequences of error. 

Thus far, your efforts are individual and private. You may 
also contribute much to the prosperity of the school, by engraft- 
ing upon it such regulations as shall offer strong motives to the 
young apothecary to come forward, and avail himself of its 
advantages. This brings us to the consideration of the second 
object, which I before stated to be essential in the institution of 
a school of pharmacy. 

In all great seminaries of learning and science, it is a practice 
sanctioned by the experience of centuries, to reward, by some 
public testimonial of approbation, those students, whose indus- 
trious application and correct deportment have given satisfaction 
to their instructors. The hope of distinction is, perhaps, the 
strongest passion of the youthful mind; and even that honour, 
which an ordinary degree in the arts confers, is sought after 
with an ardour and perseverance, which they who have forgotten 
the feelings of their earlier years can seldom fully appreciate. 
Of the thousands whom the prospect of such an honour has 
attracted into the paths of study, many have subsequently 
attained to great literary or scientific eminence, who, in all 
probability, without this original motive, would have passed 
through a life of contented ignorance. Of this principle in 
human nature, wise men will always avail themselves in their 
plans for its improvement. They will not only open the doors 
of knowledge to the young ; but will entice them to enter by the 
prospect of those trophies which exert so strong an influence 
over their imagination. The power of conferring degrees, 
attached to all collegiate institutions, may be considered almost 



16 PHARMACEUTICAL ADDRESSES. 

an essential part of their constitution ; and the practice is cer- 
tainly essential, as a general rule, to their successful operation. 
The School of Pharmacy cannot be regarded as an exception. 
I do not think I am going too far when I say, that it will never 
flourish until this practice is adopted. 

To the young apothecary, a degree from the College would be 
desirable, not only as an honour, but also as an effective instru- 
ment for the promotion of his success in business. When the 
public are generally informed, as they some time undoubtedly 
will be, of the nature and designs of the institution, it cannot 
but happen that a preference will be shown for those, to whose 
knowledge and skill its testimonial can be advanced; and, at 
some future period, a degree in pharmacy may be as indis- 
pensable to the apothecary, as that in medicine now is to the 
physician. In order, however, that the degree may have the 
greatest possible weight in the opinions of men, it should never 
be conferred on the student, till he shall have passed through a 
certain course of study and practice united, and, by an examina- 
tion before competent judges, shall have shown himself worthy 
of the honour. It should, moreover, be confined to those whose 
moral character is unexceptionable. 

The honour and advantage which I have hitherto stated as 
likely to accrue to the student from the adoption of this plan, are 
calculated strongly to attract his attention to the College, and 
to entice him within its walls. Another very important result 
will be the promotioa of increased diligence in his studies, and 
carefulness in his conduct, and consequently, his essential ad- 
vancement in knowledge and respectability of character. They 
only can estimate the influence which the prospect of being sub- 
mitted to a formal scrutiny, preparatory to the attainment of a 
highly prized honour, will always exert over the young expect- 
ant, who are able to revert to their own feelings under similar 
circumstances. It has fallen to my lot to experience in myself, 



PHARMACEUTICAL ADDRESSES. 17 

and to witness in others, strong proofs that the influence is 
powerful. Motives which have their origin in remote conse- 
quences, though these may be of the utmost importance, are 
generally less successful in rousing us to exertion, than others, 
which though comparatively trifling in their nature, are much 
more immediate in their action. It would seem as if mind and 
matter obeyed the same law of attraction ; the nearer the attract- 
ing body, the more energetic is its influence. We all know that 
a slight temptation will lead us into error, though the ultimate 
consequeuces may be incalculably injurious. I shall not, there- 
fore, be thought at variance with nature, when I advance the 
opinion, that, among the students of medicine, even those whose 
sentiments of honour are most lofty and determined, the neces- 
sity of due preparation for the trial which is to test their claims 
to a degree, has often proved a stronger incentive to active and 
persevering study, than all the considerations of future good or 
evil in the practice of their profession. The same effects must 
result from a similar cause among the students of pharmacy; 
and it follows, therefore, that, while you contribute to the wel- 
fare of the College by the adoption of the plan recommended, 
you will also accomplish, what is perhaps of still higher impor- 
tance, a much greater individual improvement among those who 
are hereafter to constitute the profession, than would result from 
their own unstimulated efforts. 

Hitherto, my observations have been confined to the College 
as a school of pharmacy. The improvement of your art has 
been contemplated, not through any direct alteration in its 
present state, but by the slow and gradual, though, in the end, 
effectual operation of a well conducted professional education. 
In calling for your support, I have addressed myself much less 
to your personal interest than to your moral sense, and your 
feelings of generosity and benevolence. But must we look alto- 
gether to the distant future for any favourable change? Can no 

2 



18 PHARMACEUTICAL ADDRESSES. 

regulations be devised, the beneficial influence of which shall be 
speedily experienced ? Before the close of this address I hope 
to prove, not only that such regulations are not impracticable, 
but that the College of Pharmacy affords you the most ample 
means of carrying them into effect. 

In every business, the entrance into which is open indiscrimi- 
nately to all, a number of individuals will invariably be found, 
whose eagerness in the acquisition of wealth is never regulated 
by principles of honour and morality. Money is their god ; the 
pursuit of gain is their religion ; honour, honesty, benevolence, 
even the safety of their own souls, are the sacrifices they are 
ever ready to offer. It is, therefore, by no means a matter of 
surprise, that, in the business of the apothecary, where, as I 
have before observed, the profit from dishonest practices is often 
great, and their detection difficult, there should prevail, to no 
inconsiderable extent, a custom of adulterating drugs, and of sell- 
ing as genuine many articles which are either entirely spurious, 
or inefficient from age, accident, or defect in their original prepa- 
ration. Though the apothecaries of Philadelphia are as little 
concerned in such practices as perhaps any similar body in the 
world, yet instances of the most criminal adulteration are known 
to have occurred ; and, with regard to some important medicines, 
the complaint of their inefficiency has been but too general and 
well founded. It is needless for me to reiterate an account of 
the evils which must result to the community from such dis- 
honest conduct : upon your whole class, upon the art itself, it is 
calculated to have the most injurious influence. An individual 
apothecary, by supplying adulterated or spurious drugs, is ena- 
bled to undersell his honest neighbours, acquires a credit he does 
not deserve, and thus attracts to himself the public patronage. 
A small degree of management is sufficient to secure him, at 
least with the great mass of his customers, from the danger 
of detection ; and, even if his fellow-dealers should be aware of 



PHARMACEUTICAL ADDRESSES. 19 

his conduct, their complaints would be considered as the result 
of envy at his success, and regret for their own inferiority. 
Either to lose their livelihood, or to cope with him by the em- 
ployment of similar means, becomes their only alternative ; and, 
to a certain extent, the practice of adulteration is rendered com- 
mon, inferior or useless medicines are universally sold, and, what 
was at first considered a most criminal procedure, comes to be 
regarded in the light of a necessary evil. The baneful effects 
are at length experienced by the people and their physicians ; 
all confidence is lost in the general honesty and competence of 
the profession ; and its character suffers, in the public opinion, 
that degradation which it had long in reality undergone. Even 
supposing the evil to have become much less extensive, still, a 
general distrust will prevail ; and the sick, unable to depend on* 
their own judgment, will rely implicitly on the recommendation 
of their medical attendants. The current of patronage wilH thus, 
in all probability, be directed to a few prominent individuals, 
with whose character for honesty and skill the physician may 
happen to be acquainted ; while many others equally merito- 
rious, but more obscure, must continue to languish, on in neglect 
and poverty. It is evidently, therefore, your, interest to eradi- 
cate this evil on its first appearance : before it shall have had 
time to strike its roots so deeply, or shoot, forth its branches so . 
vigorously, as to resist your utmost efforts for its destruction. 
In what way can this object be so conveniently accomplished as 
by the interposition of your representatives, the Trustees of the 
College, in their official capacity? As the depository of your 
interests, they will feel themselves bound to be watchful ; and, 
clothed with the authority of the whole profession, they will be 
enabled to act with promptness and energy. Fraudulent trans- 
actions will be investigated with diligence and caution; and, 
their authors, when clearly detected, if no milder measures 
should be deemed sufficient, may be exposed to the indelible 



20 PHARMACEUTICAL ADDRESSES. 

disgrace of public censure. Nor can this power, so fearful to 
the guilty, be exercised to the oppression of the innocent. The 
judicial tribunals of his country are open to every one ; and he 
whose character has been held up to unmerited ignominy, has 
there an ample opportunity of redress. Even under the im- 
probable supposition, therefore, that the majority of a respectable 
body should, from private animosity or prejudice, desire the per- 
secution of an innocent individual, still, the least degree of com- 
mon sense will teach them, that such a desire could never be 
indulged with safety. Their censure will necessarily be confined 
to those who may deserve it; and the consequence of its proper 
exercise will probably be, that it will soon altogether cease to 
be deserved. 

Abuses of a different nature from those already noticed, the 
result rather of mistaken notions of convenience and propriety 
than of dishonest intention, have crept into the practice of your 
art, and are making a silent, though not unobserved progress 
among you. To point out each one of these abuses, and to dis- 
play the extent of evil which must grow out of its encourage- 
ment, even if time were allowed me, does not come within the 
scope of my present design. I cannot, however, refrain from 
noticing one or two circumstances, which have recently attracted 
considerable attention. I have before stated my opinion, that 
the professions of pharmacy and medicine should be distinct. 
So much study, and labour, and devotion of time are necessary 
for an approach to perfection in the knowledge and practice of 
either, that he who attempts to unite them, must, to a greater 
or less degree, be deficient in both. It is the pride of Philadel- 
phia to have set the example of their separation to her sister 
cities of the Union ; and perhaps to this cause we may, in some 
measure, attribute her pre-eminence in medical reputation. The 
apothecary is especially bound to transgress, as little as pos- 
sible, the limits of his own province. Not to mention the con- 



PHARMACEUTICAL ADDRESSES. 21 

sideration, that the surrender of this department by physicians 
was a voluntary act, and therefore deserves a better return than 
an encroachment upon the portion they had reserved ; the good 
of the public, and his own ultimate interest, require a close adhe- 
rence to the duties of his proper profession. I might here 
enlarge on the evils of empirical practice ; might picture to you 
cases of pain and suffering protracted, of gentle maladies aggra- 
vated, of complaints rendered incurable, of life endangered or 
destroyed ; might lay before you the terrors of an alarmed con- 
science, the dread of public discovery, the agonies of self-con- 
demnation and remorse ; all these consequences of an unprepared 
encounter with disease I might paint in their strongest colours, 
and the picture would not be too highly charged : but at present 
I wish to advance no other dissuasive argument than the injury 
which would accrue to your own prosperity, to the solid repu- 
tation and lasting good of your profession. Do you suppose 
that medical men can with complacency behold their peculiar 
province invaded, their sources of livelihood cut off, the very 
bread taken from their mouths ? Will they not be compelled 
in self-defence to make resistance ; and can resistance be made 
anywhere so effectually as on the ground of your adversary ? 
It appears evident to me that, were it to become customary 
with apothecaries to undertake the management of diseases, 
physicians would almost universally recur to the plan they have 
abandoned, and, like their brethren in other parts of the conti- 
nent, would supply their own patients with medicine. Granting 
that this measure might not inflict a fatal wound on your busi- 
ness, it would certainly far overbalance all the emoluments you 
could derive from your medical advice. There would be brought 
into competition with you a great number of respectable men, 
whose inclination as well as power it now is to afford you en- 
couragement. You are called on, therefore, both by duty and 
interest, to discourage any attempt on the part of individuals 



22 PHARMACEUTICAL ADDRESSES, 

of your profession, to connect the practice of medicine with their 
own appropriate occupation. 

Isor is it less your policy to correct another abuse which is 
said to have made its appearance among you, derived from the 
same source, of a practical connection between the pharmaceu- 
tical and medical arts. You have been told, and I have no doubt 
with truth, that engagements have been made between the 
apothecaries and physicians, by which the former have agreed 
to share with the latter all the profits which might accrue from 
their prescriptions. We can scarcely conceive a practice, not in 
itself absolutely dishonest, better calculated than this to lead 
both parties into a course of conduct really criminal. The 
physician would be strongly tempted to prescribe unnecessarily, 
and in an oppressive manner for his patient, while, at the same 
time, he would feel little disposition to examine narrowly into 
the quality of the medicines furnished ; and the apothecary, in 
his desire to supply the deficiency in his profits, would find a 
powerful motive to lessen the original cost, if not by adultera- 
tion, at least by the purchase of inferior articles. To be effica- 
cious, the engagement must be concealed from the public knowl- 
edge j and this very secrecy affords both an inducement and a 
protection to fraudulent collusion. Other apothecaries are de- 
prived of a portion of their usual custom; and, if the plan should 
be adopted by a considerable number, it is evident that the re- 
mainder must be left almost destitute of support. The conse- 
quence, moreover, will be, either that a large portion of the just 
profits of the drug business must centre in medical men, without 
any sacrifice of time and labour, or risk of capital on their part ; 
or that the community must suffer all the baneful effects of a 
general depreciation in the quality of those articles, upon the 
purity and efficiency of which, health, happiness, and life are 
often dependent. 

While I thus draw your attention towards the abuses of your 



PHARMACEUTICAL ADDRESSES. 23 

art, I do not wish to be understood as advancing the opinion, 
that they have yet attained any alarming magnitude. Happily, 
they are still in the very first stage of their existence, feeble and 
comparatively harmless. Soon, however, if fostered by your 
neglect, they will burst their shell, and, before many years, may 
grow up into a hydra, which even the strength of Hercules 
might be unable to subdue. But the general interest of a large 
number of people, particularly when it is remote and not obvious, 
is exceedingly liable to be neglected. Each individual, occupied 
with his own private and more urgent concerns, either sees not, 
or seeing heeds not the distant evils, which, though they may 
affect himself, involve equally all his associates in their conse- 
quences. Besides, it is seldom in the power of unconnected, 
individual effort, however strenuous it may be, to destroy the 
existence, or even arrest the progress of those abuses which 
have their foundation and support in an ill-directed eagerness 
for gain. To effect such a purpose, we must render it the par- 
ticular business of a few, and devolve on those few our whole 
united influence. Here, then, we are enabled to appreciate 
another advantage to be derived from the establishment of the 
College of Pharmacy. By making it the duty of the Trustees 
to watch over the interests of the profession ; and by conferring 
on them the power to investigate and correct whatever abuses 
may originate among its members, you will obtain that union of 
individual activity with public strength, which is an indispensa- 
ble requisite to the accomplishment of any great object of general 
usefulness. Already they have evinced a disposition to guard 
with vigilance the honour and advantages of those whom they 
represent. They have raised their warning voice against one of 
those practices, which, as I before attempted to show, are preg- 
nant with evil. They have denounced, as of the most injurious 
tendency, those partnership connections with the physician, in 
which his patronage is his only capital ; and have strongly re- 



24 PHARMACETJTICAIi ADDRESSES. 

commended to all those whom their advice may influence, care- 
fully to avoid entering into such engagements. At present they 
can go no further. Their authority rests, as in this country it 
ever must and should rest, upon the basis of public opinion. To 
render them fully competent as the guardians of your profession, 
they must obtain a standing in public estimation, which shall 
give to their decisions the authority of law. The errors of igno- 
rance or inconsiderateness often require, for their correction, 
only to be pointed out ; and advice from a respectable source 
will generally prove all-sufficient : but the licentiousness of un- 
principled avarice can seldom be curbed by admonition alone. 
The hope or enjoyment of profit can, in such cases, be effectually 
opposed only by the certainty of an equal or greater loss. 
Hence, though the recommendation of the College mav have 
great influence with men of good intentions, and such, I have 
no doubt, is the great majority of your number, yet, for the 
effectual suppression of all abuses, it must be possessed of power 
to control the most unworthy, and to render it their interest to 
act uprightly. How can this power be attained, without re- 
course to the odious expedient of legislative interference ? Only 
hy a general conviction of its usefulness, among the members of 
your profession, among the practitioners of medicine, and among 
the people at large. 

The first and most essential step is, undoubtedly, to obtain 
the cordial co-operation of all the most respectable apothecaries. 
I have spoken, on this occasion, to very little purpose, if most of 
those whom I address are not convinced of the importance of 
supporting the College in the exercise of a superintending vigi- 
lance ; and conviction, in a well-constituted mind, is always 
followed by a willingness to act accordingly. You are prepared, 
therefore, to unite your influence in support of whatever meas- 
ures the College may adopt for the general good. 

To obtain the sanction of medical men, nothing further is re- 



PHARMACEUTICAL ADDRESSES. 25 

quisite than to make them fully acquainted with the nature and 
tendency of the Institution. Their own interest is deeply in- 
volved in the state of practical pharmacy ; and the College will 
receive their sincere approval, and active assistance, in its efforts 
to establish and maintain regulations, essential to the supply of 
medicines in their best possible condition. 

Public sentiment must ultimately derive its tone from the 
opinion of these two professional classes. Though quackery and 
imposture may blind a few well-informed and respectable men, 
and may impose upon many of the ignorant and simple, yet, if 
proper means be zealously employed to convey correct informa- 
tion, the great mass of citizens will, in time, be brought to see 
their own welfare concerned in the prosperity of your art, and 
will cheerfully concur in those plans which may be formed for 
its promotion. 

Thus armed with the authority of the professions both of 
pharmacy and medicine, and supported by the favourable opinion 
of the community, the College will possess a degree of strength 
which the dishonest and disreputable trader will find it impossi- 
ble to withstand. As it is weakness which principally provokes 
resistance, this very strength will produce a quiet acquiescence 
in the necessary regulations ; and the College will thus be ena- 
bled, without interruption, to go on remedying evils, correcting 
abuses, promoting just and honourable dealing, and. vigilantly 
guarding the interests, integrity, and respectability of the pro- 
fession. 

No reasonable apprehension can be indulged, that the posses- 
sion of so much power should be abused for purposes of self- 
aggrandizement; for the influence which is founded on enlight- 
ened public opinion, will inevitably be lost as soon as it shall 
cease to be merited ; and as the Trustees are a representative 
body, changeable by frequently renewed elections, they can 



26 PHARMACEUTICAL ADDRESSES. 

never carry into effect any designs which do not meet the full 
approbation of the majority of their constituents. 

I have now spoken of two great objects, attainable by a due 
encouragement of the College of Pharmacy; the first, an im- 
proved education of the young men who design to enter the pro- 
fession ; the second, such a regulation of its general concerns as 
may afford security against corrupt practices and abuses of every 
kind, and cherish upright and honourable principles in the trans- 
action of business. I will close the address by adverting to a 
third, little inferior in importance to either of the others, and for 
the attainment of which the College affords abundant opportuni- 
ties; I allude to the improvement of the materials of your art. 

With respect to those of foreign growth, an inspection might 
be instituted, under the direction of the Trustees, into the quali- 
ties of each parcel imported, and the stamp of their approval 
fixed upon all such as present the genuine characters of strength 
and purity. Inferior, useless, or vitiated medicines from abroad 
would thus find a less ready sale, and might perhaps, in the end, 
be -excluded in great measure from the market.* 

It has been ascertained that many foreign medicinal plants 
may be naturalized in our own climate, and cultivated with as 
great facility as in their native countries. With regard to such 
of these as are most active in their recent state, or require ex- 
traordinary care in their preparation, or, from their value, are 
most liable to be adulterated, it is peculiarly important that we 
should introduce their cultivation into our own immediate neigh- 

* This object has been, to a considerable degree, accomplished through 
Congressional legislation. The law for the inspection of imported drugs, 
obtained through the influence of the two professions of medicine and 
pharmacy, has effected a most happy change in the character of our drug 
market ; and adulterated, or otherwise ineffn i >nt medicines, are much less 
used than at the time when this address was delivered. 



PHARMACEUTICAL ADDRESSES. 27 

bourhood, and thus be enabled to obtain them in their highest state 
of perfection. It is, moreover, highly probable, that many of our 
indigenous plants, for a supply of which we depend solely on the 
bounty of nature, might not only be increased in quantity, but 
might also be materially improved in quality by a careful culture. 
Were the influence of the College firmly established, and its 
resources sufficiently ample, it would have the power to con- 
tribute greatly to undertakings of this nature, both by the offer 
of suitable premiums, and still more, by securing to the success- 
ful cultivator a ready sale for his produce. By similar means, 
they might promote investigations in practical pharmacy, and 
give rise perhaps to valuable discoveries, or at least great im- 
provements in the modes of preparing medicines. 

Besides enhancing the value, and enlarging the supply of 
medicines, the College might exert its influence in promoting a 
perfect uniformity in pharmaceutical processes. It is unneces- 
sary for me to inform you, that many compound preparations are 
kept in the shops, which, though they have never found a place 
in the Pharmacopoeias, are nevertheless in very extensive use, 
some of them even among medical men. It is equally unneces- 
sary to say, that great diversity has prevailed in the formulas 
employed by different apothecaries for the combination of their 
ingredients ; and that consequently evils of the greatest magni- 
tude must arise from their indiscriminate application to the 
treatment of diseases. The same remark, though not in an equal 
degree, will apply to many of the regular pharmaceutical prepa- 
rations. As no standard Pharmacopoeia has been generally 
adopted by the profession in this city, each individual is left to 
choose, from the various European authorities, those processes 
which may best accord with his own peculiar notions ; and much 
confusion has accordingly resulted, in many instances where 
those authorities differ. A suitable regulation of this branch of 
your business can be effected by no other plan so conveniently, 



28 PHARMACEUTICAL ADDRESSES. 

and with such propriety, as by the intervention of your College, 
the voice of which must be considered as expressing your col- 
lective sentiments. Nor have the Trustees been entirely idle. 
With a praiseworthy zeal for the improvement of their art, they 
have instituted inquiries into the various modes of preparing the 
patent medicines ; have selected the formulas which seemed best 
to answer the indications for which these medicines are usually 
prescribed ; and have recommended their general adoption to the 
members of the College. If properly supported, they will soon 
be able to proceed much further. In connection with the medi- 
cal faculty, and with similar institutions to their own, either now 
in existence, or which may hereafter be established through the 
United States, they may enter upon the great work of forming a 
National Pharmacopoeia. If left entirely in the hands of prac- 
tical physicians, such an undertaking must almost necessarily 
prove abortive. A minute and experimental knowledge, derived 
from long experience in pharmaceutical operations, is not less 
essential to its success, than an acquaintance with the remedial 
effects of medicines ; and this knowledge can be found only among 
the members of your profession. The College of Pharmacy 
affords decidedly the most convenient means of concentrating 
your efforts, and to its interference, therefore, we must look for 
the accomplishment of an object, which yields little in impor- 
tance to any other connected with the healing art. Should an 
American Pharmacopoeia, so constructed as to meet with general 
approbation, be one of the results of your labours and sacrifices 
in founding and maintaining this Institution, you will have 
gained the merited reputation of conferring on your own profes- 
sion, on the profession of medicine, on the country of which you 
are citizens, a great and permanent benefit.* 

* The U. S. Pharmacopoeia of 1820 was not generally recognized. But, 
soon after this address was delivered, a series of laborious investigations 



PHARMACEUTICAL ADDRESSES. 29 

Time is not allowed me to proceed further in my observations ; 
nor, were the opportunity afforded, am I aware that I could offer 
any stronger inducements than have already been presented, for 
your support of that cause, as the advocate of which I have this 
evening stood before you. Your individual honour and interest ; 
the future good of those committed, for their instruction, to your 
superintending care ; the permanent usefulness, reputation, and 
prosperity of your profession ; the health, comfort, and safety of 
your fellow-citizens ; these are objects in the pursuit of which, if 
you find no incentive to exertion, I know not by what motive I 
can address you with any possibility of success. 

But I am confident that you require no further incitement. 
You cannot but feel the importance of those purposes which 
your assistance to the College will enable it to fulfil ; nor can 
you be insensible to the disgrace, which its failure, from your 
neglect, would indelibly attach to your name and vocation. That 
in the populous, wealthy, and public-spirited City of Philadel- 
phia, the very birthplace of American medicine and pharmacy, 
and still their most favoured residence ; that here, with every 
encouragement which an enlightened population, and an influ- 
ential medical faculty can offer, more than one hundred apothe- 
caries should, by their united efforts, be unable, or, from an 
unaccountable apathy, neglect to maintain an institution, com- 
bining so many advantages as a well-regulated College of 
Pharmacy must do, is a supposition too derogatory to the char- 
acter of your profession, too humiliating to our pride as citizens, 

was set on foot, under the auspices of the College of Physicians of Phila- 
delphia, which resulted in a revision of that work, such as, when the edition 
of 1830 was published, rendered it acceptable to the professions of medicine 
and pharmacy. Since that time, it has undergone decennial revisions, 
the latest in 1870, in which the Philadelphia College of Pharmacy, and 
other pharmaceutical bodies rendered important aid ; and it may now be 
considered as the authoritative pharmaceutical code of the United States. 



30 PHARMACEUTICAL ADDRESSES. 

to be allowed one moment's indulgence. With great confidence 
we may anticipate, not perhaps an immediate, but certainly a 
high degree of ultimate prosperity for the Institution. In the 
progress of years, it will outgrow its present sick and fragile 
condition. Strong internally by its own regulations, and exter- 
nally by your unanimous support, it will be enabled to exercise 
over your profession an authority, equally beneficial to your- 
selves and to the community. Provided with ample means of 
instruction, and holding out strong inducements to studious 
application, it will diffuse copious and accurate knowledge among 
the apprentices to your art, and will greatly elevate your stand- 
ard of scientific attainment. Finally, when the division of the 
professions shall have become more general, and apothecaries 
shall be required, not only in our larger towns, but in almost 
every village of the country, it may widen the sphere of its 
attraction far beyond the limits originally contemplated, and 
render the City of Philadelphia the centre of pharmaceutical, as 
it has long been of medical instruction to the whole extent of 
the Union. 



II. 

ADDRESS TO THE GRADUATES 



OF THE 



PHILADELPHIA COLLEGE OF PHARMACY. 

DELIVERED APRIL 2nd, 1833. 



Prefatory Remarks. 

The address which follows was delivered on the occasion of the first 
public commencement in the College of Pharmacy. The degree of 
Graduate in Pharmacy had been previously conferred on a few, who had 
completed their course of study, and undergone the requisite examina- 
tion ; but the numbers had never before, I believe, been sufficient to 
warrant a public demonstration. I was at the time professor of materia 
medica in the College, having been appointed to that chair in 1831, 
when it became vacant by the death of Dr. Ellis. My colleague, at the 
time, in the chair of chemistry, was Dr. Franklin Bache, afterwards 
professor of chemistry in the Jefferson Medical College. 



THE ADDRESS. 

Young Gentlemen : — 

You have arrived at a period of your professional life, toward 
which your hopes and efforts have been directed for many years. 
Having complied with all the regulations of the College of Phar- 
macy, and acquitted yourselves with credit in the requisite ex- 

(31) 



32 PHARMACEUTICAL ADDRESSES. 

arninations, you are about to receive the honours of the institu- 
tion, and to enter, under its auspices, upon the practical duties 
of your profession. 

You must be aware that your labours are not ended with this 
change of position. The goal you have attained is only the 
starting-point of a new career. Your future course will require, 
for a successful issue, no less application, industry, perseverance, 
and self-denial, than that which is passed. In this respect it 
differs, that you will no longer have guides to direct and en- 
courage you. In the life you are about to enter, you must select 
your own objects, mark out for yourselves the paths by which 
they are to be reached, rely upon your own energies in the diffi- 
culties you will encounter, and look to your own mental re- 
sources for comfort and support in the numerous discourage- 
ments, disappointments, and partial failures, which will inevitably 
attend your progress. I need scarcely tell you that much, very 
much, will depend on your first choice of an object, and on the 
general views which you may at first take of the prospect before 
you. Should your aim be low, and your views contracted, what 
can you expect but an ignoble result? labour with little reward, 
a life without honour, a death with no permanent recollections 
behind it ; your existence fruitless, and your end, so far as re- 
lates to this world, the grave. If, on the contrary, your eye be 
fixed on some elevated point, if your spirit expand beyond the 
narrow limits of merely personal concerns, and embrace in its 
scope the general good ; what a noble field is open to your ex- 
ertions ! what a rich harvest of honour is within your reach ! 
Every step, while it raises yourselves, may be attended with 
good to others ; the approbation of your own hearts and the 
esteem of those around you may shed a happy sunshine over your 
days ; and, when your earthly race is run, you may depart, not, 
like the bird in the air, leaving no trace behind you, but with the 
pleasing consciousness of having lived up to the dignity of your 



PHARMACEUTICAL ADDRESSES. 33 

nature, of having- partially at least fulfilled the design of your 
Creator by contributing to the advancement of your race, of 
having impressed upon the condition of your profession, or the 
society in which you moved, some permanent marks of your 
labour in its cause. 

Standing, as you do, at a point of life from which so many 
paths proceed, leading to results so different, you will, perhaps, 
permit one who feels a warm interest both in your personal wel- 
fare, and in the general welfare of your profession, to make a few 
suggestions in relation to your future course, which may possibly 
have a tendency to enlighten your choice, or to confirm you in 
that to 'which your own judgment may have conducted you. It 
is not my design to press upon your attention the virtues 
requisite for great success in all honourable pursuits ; sobriety, 
industry, perseverance, honesty ; you are too well convinced of 
their importance to need any extraneous encouragement to their 
cultivation. I wish to point your attention to higher and more 
generous aims than mere personal profit ; to the improvement, 
namely, of your art, and to the elevation of the character of your 
profession. It is happily true, that the measures you may adopt 
in the pursuit of these ends will redound also to your individual 
advantage, by the increased skill and reputation you will acquire, 
independently of the general advancement of which you will 
partake as members of the profession : but, though the weakness 
of our nature requires all possible support in our nobler enter- 
prises from the selfish principle, there is, nevertheless, I believe, 
a feeling within us, which prompts to great and generous actions 
without the necessary expectation of personal reward. This is 
found especially in the warm heart of youth, and, like every 
other, is enlarged and strengthened by frequent exercise. To 
this feeling I would appeal, and, without excluding less elevated 
motives of action, would call on you to exert yourselves stren- 
uously for the improvement of your profession, the honour of 

3 



34 PHARMACEUTICAL ADDRESSES. 

your calling, and the consequent good of the community in gen- 
eral. Should you demand in what manner these ends may be 
best promoted, I would answer by referring to the history of 
your profession, and pointing to the causes which have operated 
in raising it from its former humility to its present comparatively 
elevated position. 

The period is not very remote, when the apothecary was 
almost at the lowest extremity of that scale, which measures 
the relative respectability of occupations above mere manual 
labour. Engaged in preparing or compounding medicines ac- 
cording to certain fixed formulas, with little or no knowledge 
of the priuciples concerned in his operations, he could boast of 
superiority over the pastry-cook or confectioner, in no other 
respect than in the greater variety and importance of the mate- 
rials of his art; and, while the nature of certain offices about 
the sick to which he was occasionally subjected exposed him to 
the sneers of the vulgar, the assumption of a character for re- 
search into the mysteries of nature, supported by the exhibition 
of reptiles and various monsters upon his shelves, made him the 
subject of ridicule with those who were aware of the real weak- 
ness of his pretensions. The apothecary, therefore, became the 
jest of the novelist and comedian ; and so little was the humility 
of his occupation compensated by pecuniary advantages, that 
he was chosen by the wits of the time as the very personifica- 
tion of poverty and leanness. 

In this country, pharmacy was at first almost universally, as 
it still is in many places, united with medicine. To do justice 
to the two occupations of the physician and apothecary was 
utterly impossible for any man of ordinary endowments. That 
was, therefore, neglected which was deemed of least importance; 
and the' practitioner was too much in the habit of leaving the 
preparation and dispensing of medicines to his students, who 
necessarily knew little upon the subject, though, it is true, not 



PHARMACEUTICAL ADDRESSES. 35 

much less than himself. How was it possible for pharmacy to 
flourish, or attain respect under these circumstances? Over- 
shadowed as it was by the sister profession with which it had 
been planted, its growth was mean and stunted, though still 
sufficient to abstract a portion of the nourishment, and thus re- 
strain also the growth of its companion. No wonder that it was 
looked upon in a degrading light! No wonder that men of edu- 
cation and a generous spirit were unwilling to place themselves 
behind the counter to dispense potions and powders, when no 
other qualifications were requisite for the task than such as are 
requisite for the selling of tape and bobbin. Even medicine was 
less esteemed in such an association ; and young men of elevated 
views and respectable station in society were not then as now 
seen crowding the ranks of that profession. - That in some part s 
of the world, the business of the apothecary may not have been 
disreputable, and that in all parts individuals occasionally by 
their talents or conduct raised themselves above the mass of 
their associates into notice and esteem, is no proof that the gen- 
eral grade of the profession was not as low as I have described 
it; any more than the occasional incompetence of individuals 
now attached to the profession, and its comparative discredit in 
certain countries, can be received as evidence of its want of re- 
spectability at the present day. 

Admitting, as every one must do, who has the least pretension 
to accurate information on the subject, that the present state of 
the profession is in many respects the reverse of its former state, 
that almost everywhere pharmacy is now respectable, and that 
in some places it has been elevated to a position calculated to 
reflect positive credit upon those engaged in it, let us briefly in- 
quire into the means by which so great a change has been 
effected. It certainly has- not been solely in consequence of the 
progress of the world in knowledge and the arts of civilization ; 
for the condition of the profession would, in this case, bear the 



36 PHARMACEUTICAL ADDRESSES. 

same relation as formerly to others, and, though it might have 
become more efficient in contributing to the general good, it 
could not have advanced in respectability, which may be con- 
sidered as altogether relative. The causes, therefore, which 
have produced its elevation must be in some measure peculiar ; 
and, if ascertained and applied hereafter with increased energy, 
will promote, in a still greater degree, the same upward progress. 
Among the most prominent of these causes, and that which 
was the first to operate, was a dissolution of the union which 
originally existed between the two professions of medicine and 
pharmacy. It is not my intention to trace the gradual steps of 
this separation; to mark the frequently hesitating and reluctant 
recession of the physician from a source of accustomed profit, or 
the disposition which the apothecary as frequently evinced to 
step over the boundary line, and harvest in the fields of practical 
medicine. It is sufficient to observe that wherever the separa- 
tion is complete, pharmacy has assumed a position decidedly 
more elevated than formerly, and much superior to that which 
she at present holds where the separation has not been effected. 
I need only compare Great Britain and France, the former 
making few improvements in the science, and most of these 
through the instrumentality of physicians, the latter sending 
forth discoveries in rapid succession, and acquiring by the 
labour of her pharmaceutists increased national fame, while she 
is benefiting the world. In the former, the apothecary is half 
pharmaceutist and half physician, and consequently is good for 
little in either capacity; in the latter, the two professions are 
entirely distinct, and both in a condition of rapid advancement.* 

* It will he noticed that these remarks apply to the times at which the 
address was delivered. The condition of things has since then very mate- 
rially changed in England. The pharmaceutists have erected themselves 
into a distinct profession, and have made rapid advances in their art ; 



PHARMACEUTICAL ADDRESSES. 37 

If we come home, and examine into the relative condition of 
pharmacy in different parts of the Union, shall we not at the 
first glance fix upon our own city as pre-eminent ; and where 
else, within this country, have the professions been so long 
divided? That this cause is capable of producing the effects 
attributed to it, is almost too evident to require the support of 
argument. The pharmaceutist, while struggling to acquire a 
faint insight into disease, and burdened with the responsibility 
of patients whose lives are in his hands, has his mental energies 
and anxieties too much enlisted in the practice of medicine, to be 
able to do justice to his more legitimate pursuit. Not only, 
therefore, are his time, attention, and interest divided between 
two objects, each of which is sufficient to absorb the whole ; but 
one of these objects becomes in his estimation of paramount im- 
portance, and throws the other comparatively into shade. It 
almost always happens that, when medicine and pharmacy are 
conjoined, the latter suffers most, because less immediately and 
forcibly called into action. When, on the contrary, the apothe- 
cary confines himself exclusively to his own profession, he gives 
up to it his whole time, and, feeling his dependence on it for 
support, fortune, and reputation, is induced, if possessed of a 
spirit of enterprise and ambition, to exert himself to the utmost 
to increase its resources, and elevate its character. To this total 
separation, therefore, we may trace, as to their source, most of 
the other causes of improvement which were brought into opera- 
tion. They were all such as sprang from the awakened energies 
of the individual members of the profession. 

Out of this zeal arose the establishment of pharmaceutical 

while there is a strong and increasing tendency in medical practitioners 
to throw off entirely the business of preparing and selling medicines. 
Before many years, it is probable that the mongrel race of apothecaries 
in England will have entirely disappeared ; and the two professions of 
medicine and pharmacy be recognized as distinct. 



38 PHARMACEUTICAL ADDRESSES. 

schools, which, in all places where they have been in full opera- 
tion, have produced the most decidedly favourable effects ; and, 
next to the original cause already stated, have been the instru- 
ment of more good in the diffusion of knowledge, the promotion 
of a spirit of enterprise and investigation, and the establishment 
of a common professional feeling, than any other that could be 
mentioned. I appeal to every apothecary who has resided during 
the last fifteen years in Philadelphia, whether this remark is not 
justified by his observations of the influence of that school, in 
the hall of which we are now assembled. The apothecaries of 
Philadelphia, in the establishment and support of the College 
of Pharmacy, have evinced an intelligence and foresight which 
do them great honour, and of which they have, as a body, 
already begun to reap the legitimate fruits, in a wider diffusion 
of intelligence and enterprise, and a more elevated position in 
the social scale.* 

The professional spirit, fostered by schools and collegiate asso- 

* Justice requires that some allusion should here be made to the services 
of a gentleman, to whom the pharmacy of this country is greatly indebted ; 
I refer to Daniel B. Smith, formerly President of the Philadelphia Col- 
lege of Pharmacy. Standing among the first of the apothecaries of his 
time in literary and scientific attainment, peculiar skill in his art, and 
general reputation, he entered zealously into the movement which origi- 
nated and sustained the College of Pharmacy; and, by his own written 
contributions, the encouragement which he extended to the efforts of 
younger men, and the measures set on foot, or ardently supported by him, 
for the improvement, in various ways, of the profession to which he was 
attached, he contributed, I think, more than any other one individual, 
to the impetus which has carried the pharmacy of this country to its 
present relatively high position. Should this notice reach him in his retire- 
ment, the author hopes that he will receive it kindly, as the testimony of 
one who has known him for more than fifty years, has always esteemed 
him highly, and entertains a grateful sense of the early aid and encourage- 
ment extended by him to his own professional labours. 



PHARMACEUTICAL ADDRESSES. 39 

ciaticms, is one of the most efficient results of their favourable in- 
fluence. By this principle I do not mean a community of feeling 
in any particular body of men, as to measures calculated to 
promote their pecuniary interests. This is almost universally 
prevalent, and, in the illiberal character of its action, is probably 
productive of as much injury as benefit. Dividing the community 
into classes, it causes each to exert itself for the acquisition of 
peculiar advantages, at the expense of the others, and thus occa- 
sions hostility among neighbours, and diffuses an evil feeling, 
which is felt through all the ramifications of society. It has its 
foundation essentially in selfishness, and, under the pretense of 
working for the good of the class, is in fact directed altogether 
to individual profit. The principle to which I allude is of a dif- 
ferent character. It looks primarily to the honour of the calling, 
secondarily to the advancement of self. Based upon the generous 
emotions of the heart, it has nothing in it mean and low, and 
scorns even the attainment of its own ends by other than honour- 
able means. True professional spirit prompts, not to raise the 
relative position of one's own calling by depressing that of others, 
but to effect its positive elevation by industry, enterprise, vigor- 
ous personal effort, and careful personal deportment. It thus 
comes in aid of the disposition to raise the standard of one's own 
attainments and character, and, while it promotes the general 
good, promotes that of the individual in a still higher degree. 
Its tendency is to render every member of the profession a more 
industrious, a more honest, and more honourable man. 

With such causes as those I have mentioned in operation, it 
was not possible that pharmacy should remain in that state of 
depression, in which it existed before their development. Con- 
fined to their own legitimate pursuit, the apothecaries began 
to exert themselves for the improvement of its resources. 
Looking abroad into the fields of natural science, they observed 
much that could be advantageously applied to their art, and 



40 PHARMACEUTICAL ADDRESSES. 

therefore turned their attention to the cultivation of the different 
branches of this kind of knowledge. The establishment of schools 
fostered habits of study, and, by giving a proper direction to the 
industry of the pupils, caused them to apply their time and 
talents efficiently, and not to waste them, as the uninstructed 
are too apt to do, in fruitless because ill-directed efforts. A 
professional spirit was at length developed. This gave renewed 
energy to the enterprising, instilled animation even into the dull, 
and breathed into the whole body one common soul of life and 
activity. Happily the advanced state of those sciences which 
have a bearing on pharmacy, afforded to this newly awakened 
spirit materials upon which to act with advantage. Chemistry, 
as the science most deeply interested in all the operations of the 
apothecary, was cultivated with peculiar zeal and success. Light 
broke upon the art from every side, and penetrated even its dark- 
est recesses. The confused mass of facts and absurdities which 
had accumulated, during ages of ignorance and superstition, 
experienced under this regenerating influence an internal fer- 
mentation, which, separating error from truth, gradually threw 
off what was noxious and superfluous, and combined the remain- 
ing materials into new forms of usefulness. What had before 
been merely a business or an art, began now to assume the 
dignity at the same time of a science and a liberal profession. 
The ascent of pharmacy was rapid ; and every step, while it 
widened her prospect, and brought new resources into view and 
action, elevated her also in the eyes of the world, and thus 
increased at once her usefulness and credit. To the present time 
she has suffered no intermission in her progress ; and, in some 
parts of Europe, she has gained that position of equality among 
other liberal pursuits, to which her nature entitles her, and which 
she had been prevented from attaining only by extraneous causes 
repressing her inherent energies. In France, her votaries are at 
this moment little inferior to those of any other profession in 



PHARMACEUTICAL ADDRESSES. 41 

scientific attainment. Discoveries honourable in themselves, 
and of vast importance to the human race, have resulted from 
the labours of pharmaceutists; works of great value on different 
branches of the art have been put forth by men of the same pro- 
fession ; and the names of apothecaries might be mentioned, 
which, in all that constitutes true honour and greatness, might 
stand by the side of those now highest in the world. 

Do not understand me as asserting that the pharmacy of this 
country has attained an equal elevation. It has, indeed, within 
a few years been rapidly advancing, from the commencing opera- 
tion of causes alreadv alluded to ; but it is vet far behind that of 
continental Europe. The field, however, is open, and there is 
no want of hands to labour. Let them be under the influence of 
a proper spirit, and the guidance of proper principles, and they 
will work out here the same results. You, young gentlemen, 
are among the labourers to whom the profession is anxiously 
looking for support. Your predecessors have done much ; but 
they could not accomplish all. To you belongs the task of roll- 
ing on the accumulating ball which they have put in motion. 
You have seen the steps by which your professional brethren on 
the other side of the Atlantic have attained to eminence. I can 
do no better than point to their example, and bid you follow.* 

Let me, however, for a few minutes, recall your attention to 
the means which experience has indicated, and reason approves, 
as the most efficient. 

The first consideration which I desire particularly to impress 
on your minds is the importance of entirely abstaining from the 

* It is due to the pharmaceutical profession in this country, to state 
that the anticipations, put forth in this address nearly forty years ago, 
have been in a great degree realized. The profession now abounds in 
men of real science ; many discoveries and improvements have been made 
by the pharmaceutists educated in this school ; and the general standard 
of practical skill and thorough knowledge has been greatly elevated. 



42 PHARMACEUTICAL ADDRESSES. 

treatment of disease. You have seen that the separation of 
pharmacy from medicine was the first and most essential step 
towards giving respectability to the former. The separation, 
however, has not been completely effected in this country. Phy- 
sicians are in many places their own apothecaries ; and, even in 
Philadelphia, we find a disposition in each profession to encroach, 
in individual instances, upon the legitimate province of the other. 
Am I mistaken in the opinion, that this disposition is much more 
general in the profession to which you are attached than in that 
of medicine ? So long as this continues, admitting it to be so, 
it will be impossible for pharmacy to attain that excellence in 
itself, and that respect in the eyes of the world which ought to 
belong to it. Independently of the consideration previously 
urged, that the distraction of time and attention will prevent the 
due cultivation both of the science and practice of pharmacy, 
there are others which should have their influence on the mind 
of the apothecary. If the physician find a determined inter- 
ference in his pursuits, diminishing the profits of his labour, and 
actually taking the bread out of his mouth, will he not be com- 
pelled to abandon the ground he has taken, and attempt to add 
the profits upon the medicines which he prescribes to his other 
resources ? Will he not thus necessarily contract the business 
of the apothecary, and deprive the latter, to a great extent at 
least, of the opportunity of treating disease, by directing every 
applicant for medical aid to his own establishment ? Grant that 
he may thus degrade his own profession ; but we all know that 
necessity will generally triumph over opinion ; and the most 
high-minded men may be compelled, by the prospect of starva- 
tion, to courses which they would not under other circumstances 
approve. There can, I think, be little doubt, from the relations 
which the two professions respectively bear to the sick, that, if 
they are brought into conflict, pharmacy will most essentially 
suffer: — how short-sighted, therefore, is that course, which for 



PHARMACEUTICAL ADDRESSES. 43 

the sake of a little temporary and doubtful pecuniary advantage, 
will risk the production of such a conflict. But this is not all. 
By attempting to perform offices for which you are not qualified 
by previous study, you necessarily degrade yourselves and the 
profession to which you belong. In this particular instance, you 
incur the risk of injury to others, at the contemplation of which 
a properly regulated mind would shudder. What would you 
think of a man, who, without any acquaintance with medicines, 
should attempt to perform the office of an apothecary ? Would 
he not run the most fearful hazard of inflicting serious, perhaps 
fatal injury upon others ? You can readily understand how 
wholly unfit he must be for the business he has undertaken ; and 
you are all prepared to feel for him the due degree of contempt 
or repugnance. Would you not be in precisely the same situa- 
tion in attempting to practice medicine ? Believe me that the 
studies which are calculated to make a good apothecary, give 
not the least insight into the proper mode of managing disease. 
To understand this, a knowledge of the human system both in 
its healthy and morbid conditions is absolutely essential ; and an 
acquaintance with medicines alone, so far from being sufficient, 
will often be even worse than useless by inducing a false con- 
fidence, and thus preventing the caution that one wholly unac- 
quainted with the subject would feel himself bound to observe. 
I have no hesitation in expressing my belief, that an apothecary, 
who, without proper study, should assume the functions of a 
physician, would, as a general rule, be in greater danger of doing 
mischief than the most ignorant empiric ; as the latter, aware of 
his incompetence, will often confine himself to comparatively 
innocent means, and therefore leave nature an opportunity of 
effecting a cure ; while the former, familiar with the preparation 
of the dangerous instruments with which he is surrounded, might 
suppose that he knew how to employ them, and thus be tempted 
to the most hazardous experiments. If, then, you regard with 



44 PHARMACEUTICAL ADDRESSES. 

little respect the individual who empirically practices your own 
profession, how must the instructed physician regard the apothe- 
cary, who, without suitable preparation, attempts to practice 
medicine? I am certain, my young friends, that you are not 
willing to incur this odium. Your own proper self-respect will 
secure you against the temptation, which a little pitiful pecuniary 
profit may offer. You will be too proud of your profession as 
apothecaries, to be willing to sink into mere quacks. Should 
you desire to change professions, you will enter the fold of medi- 
cine, not over the wall like a thief in the night, but by the regular 
and legitimate path of laborious study: but your best plan is to 
persevere in the course which you have so reputably commenced. 
Your profession is honourable. In its essential nature, there is 
nothing which should prevent it from stauding on a footing of 
perfect equality, in the estimation of the world, with any other 
pursuit to which man is addicted. Be it your ambition to assist 
in placing it upon such a footing by your labours and conduct. 
But this end, be assured, you never can attain, if you mingle 
with your proper pursuits those of other professions having no 
essential connection with your own. 

There is another point in relation to this subject which merits 
attention. You prepare and dispense medicines according to cer- 
tain known and recognized principles. Does it also form a legiti- 
mate part of your occupation, to sell those with the composition 
and character of which you are unacquainted ; upon the purity 
of which you are unable to form an opinion; which, for aught you 
know, may contain the most deadly poisons, and may produce the 
most injurious effects upon the health of the community ? Is it 
sufficient for your justification, that these secret nostrums have 
upon them the stamp of some ignorant knave, who claims an in- 
tuitive insight into the nature of disease, and a miraculous power 
to apply the suitable remedy ? I submit it to your own sense 
of honour, whether it accords with your personal dignity to be 



PHARMACEUTICAL ADDRESSES. 45 

the agent of empiricism ; whether your profession is not somewhat 
degraded, when she stoops to become the handmaid of impudent 
imposture. Though not one of her peculiar votaries, I esteem 
and love her too much to see her thus degraded without deep 
regret ; and I cannot but hope that you will participate my feel- 
ings, and that by your hands those trammels will be removed, 
which bind her to so low a servitude. 

But it is not enough to confine yourselves exclusively to your 
own pursuit. You should endeavour to promote its interests by 
a diligent cultivation of all those branches of knowledge which 
have an important bearing upon its practice. You have hitherto 
acquired but the rudiments of the sciences that constitute the 
study of pharmacy. The path has been cleared for your en- 
trance ; but much patient labour will be necessary before you can 
penetrate all its recesses, and become masters of all its secrets. 
Even to keep pace with the progress of discovery, will require 
the devotion of no small portion of your attention. Having 
rendered yourselves familiar with all that is valuable of what 
is already known, you will be prepared to become candidates for 
fame in the career of discovery. Whether successful or not in 
gaining any high prize, your character as men of intelligence will 
be evident, and the public, observing in your example the con- 
nection between pharmacy and science, will be led to form a more 
elevated opinion of the art. There is one caution, in relation to 
experimental investigations, which I wish strongly to impress on 
your attention. Do not be in too great haste to promulgate any 
-results you may have attained, which may strike you as new or 
interesting. It is a common fault, particularly in this country, 
to aim at speedy distinction ; to search for some short and easy 
path to fame. Men unprepared by previous study or practice, 
enter at once into the course as competitors with those of the 
most careful training. Meeting with some result which appears 
new to them, in consequence of their own want of information, 



~_ : 



the j proclaim it prematurel y to the world, only to learn from 
the greater experience of others, that their supposed discovery is 

s. ~zii-£i :~z :\i:: :: i".:::7::r: :'.'.:«:;: I'isitt zz:t i iz :'i-zi: 
first attempt, they are apt to sink into discouragement, and to 
abandon a pursuit, which, under proper direction at first, might 

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r~r=f~rriz:i zzzz: ?zili ; :z Tr~i::.r: ~zz 5i::-r = = 

Analytical investigations of the various materials and products 
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tion. Br::rf f:"T:::: :z "::_ z: — -•:-: 7:: =h:~'5 be :i:r- 
onghly imbued with the scientific principles which have any bear- 
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contrivances or modifications of the process which it may suggest 
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iex:er::j ir^i* ::e dzzz: :zz^r= :::_t sz^z^ ;::z::z^ 
chemists of continental Europe : and study carefully the obser- 
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accuracy of the results you may obtain. Your dis- 
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PHARMACEUTICAL ADDRESSES. 47 

other causes. However learned, however successful in scientific 
pursuits, individuals may be, they cannot render their calling re- 
spectable, without uniting with their other attainments the qual- 
ities which characterize the gentleman. These qualities, there- 
fore, it becomes 3~ou to cultivate with the most sedulous care. 
A proper sense of what is due to yourselves and others, aversion 
from whatever is mean or base, contempt even of wealth united 
with dishonour ; these sentiments, co-operating with courtesy of 
manner, will ensure you a respect from all the better classes of 
society which will extend also to your calling. It is a false 
notion that attention to petty details of business is incompatible 
with gentlemanly feelings and habits. If the business be, as 
yours certainly is, of a nature calling for mental cultivation and 
scientific attainment ; if its proper exercise require, in an especial 
degree, upright principles of conduct ; if it be calculated, accord- 
ing as it is well or ill conducted, to do much good or inflict much 
evil ; it is undoubtedly entitled to a place among the most re- 
spectable occupations, however minute and apparently trivial may 
be some of its offices, and however small may be the items in 
which its profits are received. It would be false shame that 
would deter from any, even the minutest detail of the apothe- 
cary's calling. No one is in the remotest degree incompatible 
with the cultivation of the nicest and noblest feelings of honour, 
the possession of the most elevated sentiments and principles, 
the practice of all those courtesies of manner, and those obser- 
vances of society, which tend so much to soften the asperities of 
life, and to lend additional charms to its enjoyments. Without, 
therefore, neglecting the details of your business, endeavour to 
imbue yourselves with elevated feelings and principles, to regu- 
late your deportment in all cases according to the nicest rules of 
propriety and justice, to become, in a word, all that ought to be 
included in the idea of a gentleman. Thus endowed, and thus 
acting, possessed at the same time of an accurate knowledge of 



48 PHARMACEUTICAL ADDRESSES. 

the pharmaceutical sciences, and devoting your energies to their 
enlargement, what men in the community would stand or de- 
serve to stand higher than yourselves ? Your example would 
extend its happy influence to those who might accompany or suc- 
ceed you in the same occupation; the force of emulation, and the 
natural craving of the cultivated mind after further improvement, 
would urge to renewed efforts and more scrupulous care ; and, in 
all future times, your profession might exhibit, in her ampler de- 
velopment, more harmonious proportions, and loftier bearing, the 
ineffaceable marks of that life and spirit which you would have 
contributed to inspire. 

The observations hitherto made refer to your individual and 
separate exertions. Much may also be effected, with little addi- 
tional labour, by such a combination as will give to your actions 
a common direction, and a unison of character. The opportunity 
for this combination is afforded by the Institution in which you 
have been educated. The College of Pharmacy invites you to 
enter freely, to partake of all her advantages, and to join with 
her in working for the public benefit. Upon you, indeed, she de- 
pends for the extension of her means of doing good. Receiving 
no assistance from the government of the country, endowed with 
no exclusive privileges, and resting solely for her prosperity and 
even existence upon the basis of public opinion, she demands the 
warm and active support of all those concerned for the good of 
the body, whose interests she was designed especially to promote. 
Your predecessors have done their part nobly, first in establish- 
ing the College, and subsequently in labouring for its mainten- 
ance through all the discouragements and difficulties incident to 
a new undertaking, calculated rather for future than immediate 
good, rather for the benefit of the successors of those originally 
concerned in it, than their own. You have been among those 
benefited. In addition, therefore, to those public-spirited and 
magnanimous feelings which actuated the founders of the Insti- 



PHARMACEUTICAL ADDRESSES. 49 

tution, you have the sense of favours received to actuate you. 
The College has a right to expect your warm co-operation. She 
appeals to you not only as good citizens and honourable members 
of the profession, but also as children bound to her by filial ties ; 
and I doubt not that her call will be answered. You will enrol 
yourselves among her members, will zealously labour in sustain- 
ing her measures and enlarging her sphere of usefulness, and, 
through these means, will more than repay, in advantages to 
those who may follow you, the debt of gratitude which you owe 
to your predecessors. 



LECTURES, 



INTRODUCTORY 



COURSES ON MATERIA MEDICA AND PHARMACY, 



IN THE 



UNIVERSITY OF PENNSYLVANIA. 



INTRODUCTORY LECTURES 

ON MATERIA MEDICA 



AND 



PHARMACY. 



Prefatory Remarks. 

The series of Introductory Lectures which follow have reference to 
the subject of Materia Medica, and were all delivered to medical classes 
in the University of Pennsylvania. They were designed to give instruc- 
tion on various points connected with this science, which could not be 
conveniently considered in the body of the annual courses. The most 
prominent of these points are 1. the general history of the Materia 
Medica, 2. its special history in the United States, 3. its character and 
importance, 4. the abuses to which it is most liable, 5. the influence of 
mental agencies in a therapeutical point of view, and 6. the principles 
which should regulate the choice of medicines. 

The lectures are not here presented exactly in the succession in which 
they were delivered, but rather in the natural order of the subjects. 
They were read at different times between the year 1835, when I was 
chosen professor of Materia Medica and Pharmacy in the University, 
and the year 1850, when I was transferred to the chair of the Practice. 
The reader will find in them observations, reflections, and opinions, 

(53) 



54 INTRODUCTORY LECTrRES. 

which have been the result of much experience, and of a long attention 
to the subject ; and which, I cannot but hope, may have some value for 
the young medical man, who has not hitherto had opportanities equal to 
those of the author. The thoughts contained in them were not hastily 
thrown together, but were the result of mature deliberation ; and the 
lectures themselves, so far as the matter is concerned, were elaborated 
with no little care. 



LECTURE I. 



DELIVERED NOVEMBER 7th, 1843. 



History of Materia Medica. 

I greet you all, gentlemen, most cordially. We are begin- 
ning a long work together. Let us join in it heart and hand. 
We shall thus not only do more, but shall have increased pleasure 
in what we do. Labour itself, when directed to a useful end, is 
never without its satisfaction. A sweet melody, that sleeps every- 
where in nature, is awakened by a series even of solitary effort. 
But the music is heightened into a delightful harmony, when we 
touch the strings together and in concord. 

I need not tell you that our field of joint labour is that of ma- 
teria medica and pharmacy, or the science of pharmacology. 
Over this field let us throw a hasty glance before entering it. 

We do not require history to inform us that the origin of the 
materia medica was nearly coeval with that of disease. Bodily 
suffering and the fear of death are eager and quick-sighted search- 
ers after means of relief and safety ; and nature is seldom nig- 
gardly when approached with an earnestly inquiring spirit. No 
tribe is so savage as not to have its little catalogue of remedies. 
The earliest records of the human race refer incidentally to the 
existence, not only of medicines, but of the art of preparing 
them. In the thirtieth chapter of the Mosaic Book of Exodus, 

(55) 



56 HISTORY OP MATERIA MEDICA. 

written probably nearly 1500 years before Christ, is the follow- 
ing injunction. "And thou shalt make it a perfume, a confection 
after the art of the apothecary." This is the first recorded notice, 
so far as I know, upon the subject of medicine and pharmacy. 
From other passages in Scripture, there is reason to believe that 
our art was cultivated, and in great esteem among the Hebrews. 

The fabulous history of the early Greeks affords evidence that 
they also had their materia medica, and held the office of the 
physician in high honour. Pausanias relates that Melampus, 
who is supposed to have lived anterior to the Trojan war, cured 
the daughters of a king of Argos of mental disorder by means 
of hellebore, and received as a reward the hand of one of his 
patients and a third of her father's kingdom ; and Esculapius, 
who practised the art of healing at a somewhat later period, was 
made a god after his death, and had temples erected to his honour 
in various parts of Greece. 

It is altogether probable that both the Hebrews and Greeks 
derived the rudiments of their materia medica from Egypt. 
Whatever knowledge, other than that revealed in the wilderness, 
the Israelites took with them into Canaan, must have been ac- 
quired in the country of their birth and long bondage ; and the 
early legends of the Greeks point to the same land as a place of 
philosophic pilgrimage, where those ambitious of enlightening 
their native country deemed it necessary to pay a preliminary 
homage at the shrine of science. Melampus is said to have 
brought his medical knowledge out of Egypt ; and some have 
conjectured that Esculapius, instead of being of Grecian birth, 
was an Egyptian god adopted by the Greeks. 

The list of medicines in these remote times was extremely 
meager, consisting chiefly of substances intended for external 
use. In the cure of internal disorders, as they arose from un- 
seen and mysterious influences, reliance was placed chiefly upon 
equally mysterious remedies ; upon charms and sorceries, upon 



HISTORY OF MATERIA MEDICA. 57 

propitiatory prayers, sacrifices, and gifts, which might avert 
some supernatural malice or vengeance, or secure the favourable 
interposition of some health-giving deity. 

A materia medica of this character fell naturally into the 
hands of the priesthood. Accordingly, among the early Greeks 
the temples of Esculapius were the chief resort of the sick ; and 
the priests of that god, who were also his reputed descendants, 
and known by the family name of the Aselepiadae, enjoyed an 
almost exclusive monopoly of the practice of medicine. The 
knowledge they possessed was handed down, either orally or 
through the secret records of their temples, for a long succession 
of generations, and must have gone on gradually accumulating, 
as the necessary result of continued observation and experiment. 
This knowledge was first made accessible to the world through 
the writings of Hippocrates, who was himself one of the 
favoured family, had studied in the school of Cos, one of the 
most famous of the Esculapian temples, and was thoroughly 
initiated in all the secrets of the brotherhood. To these writings 
we must have recourse in forming our opinion of the condition 
of medical science in general, and consequently of our own 
branch in particular, at the most flourishing period of Grecian 
civilization. 

From their contents we should not infer that materia medica 
had made very great advances. Of the substances employed 
little more is mentioned than their names; and, from the un- 
certainty of the nomenclature, and the absence of precise de- 
scription, it is impossible, in most instances, to determine as to 
their identity with those now in use. Even in cases where the 
ancient and modern designations are the same or similar, it does 
not follow that the substances designated are identical ; for 
nothing is more common than the diversion of a name from its 
original application. There is, however, good reason for think- 
ing that several medicines, which stand high in modern cata- 



58 HISTORY OF MATERIA MEDICA. 

logues, were used in the time of Hippocrates. Among them 
may be mentioned black hellebore, elaterium, scammony, squill, 
myrrh, galls, and that most invaluable of medicines, opium, for 
which alone, had antiquity bequeathed us no other gift, we 
should be bound to it in endless gratitude. 

From the time of Hippocrates, who died about 3*70 years be- 
fore Christ, to that of Dioscorides, in the first century of our 
era, the materia medica underwent a gradual process of accumu- 
lation. It is probable that the medical sect denominated Em- 
pirics, which arose during the interval, contributed most largely 
to this increase. Sensible men were they who, in those times, 
could break loose from the trammels of speculation, and devote 
themselves exclusively to observation, experiment, and close 
induction. A vain notion appears to have taken possession of 
the minds of men calling themselves philosophers, that an in- 
dustrious digging in the earth after truth was unfit occupation 
for one who could soar into the loftier and purer region of the 
spiritual. In their silly pride of intellect, they deemed that they 
could fathom the depth of creative wisdom, enter into the coun- 
sels of omnipotence, and comprehend the principles of things by 
their own mental energy. Usurping the functions of deity, 
they made for themselves hypothetical creations, into which 
they forced the things of nature, torturing them into all sorts of 
strange shapes to suit the measures of their fancy. Medicine, 
like every other science, was infected by this insanity of specu- 
lation. The Dogmatical physicians, as they were called, seated 
securely in their own imaginary truths, looked out with con- 
tempt upon the humble labours of research. Happily, their prin- 
ciples have in modern times fallen into disrepute ; and the 
esteem in which they are now held may be measured by the dis- 
credit attached to the very title of the sect. Dogmatism is but 
another name for self-confident ignorance. Nor, in truth, has it 
fared much better with the Empirics. This sect was founded in 



HISTORY OF MATERIA MEDICA. 59 

just principles. To observe, to experiment, to infer carefully, 
and to record, such was the course marked out for themselves in 
the search of truth ; and such must ever be the course of those 
who expect to find it. But the Empirics did not carry out their 
own principles. While they sought new remedies, investigated 
the properties of those known, and tried the effect of various 
combination; they undervalued anatomy, neglected the study of 
disease, and fell into the fatal error of prescribing merely for a 
name. With their eyes fixed constantly on medicines, they 
could at length see nothing beside. Certain substances began 
to stand prominently out in their field of vision, and soon ab- 
sorbed their whole attention and faith. Hence came nostrums 
and panaceas, and the inseparable attendance of loud boasting 
and confident promise. The scientific gave way to the sordid. 
The mysterious aid of secrecy was invoked. Fraud mingled in 
various proportion with self-deception. The stream which had 
issued pure from its fountain, became more and more contami- 
nated as it pursued its downward course through the baser 
feelings of our nature, till at length it ended in the kennel. The 
name of Empiric became a badge of dishonour, a mere synonyme 
of quack. There is little doubt, however, that the sect added 
much to the resources of the materia medica ; though it remained 
for later times to make these resources available for practical 
good. 

It was probably during this period that the rage for multi- 
plicity in the combination of medicines originated. Substances 
of the most heterogeneous character were mixed together in great 
numbers, upon no other grounds apparently than the hope that 
some one of them might be found effective, or that, in this hap- 
hazard pharmaceutical gambling, some lucky combination might 
occur to be set off against a thousand failures. Occasionally one 
of these luxuriant mixtures appeared to stand the test of trial, 
and obtained a more or less permanent reputation. Two of the 



60 HISTORY OE MATERIA MEDIC A. 

most famous were the Antidote of Mithridates, so called after 
its supposed inventor, the celebrated king of Pontus, and the 
Theriac of Andromachus, which originated with the physician 
of Nero whose name it bears. The former contained 54, the 
latter from 60 to 70 ingredients. In the view of modern science, 
they are both in the highest degree absurd ; but they continued 
in great credit until a comparatively recent period ; and the 
Theriac still encumbers and disgraces tjie national pharmacopoeia 
of France. 

A necessary consequence of this endless complexity of com- 
position was the separation, to a certain extent, of the art of 
preparing from that of prescribing medicines. Each was abun- 
dantly sufficient to give occupation to one set of men. So early 
as in the third century anterior to our era, many physicians of 
Alexandria, then the seat of a celebrated school of philosophy 
and medicine, under the patronage of the Ptolemies, are said to 
have devoted themselves exclusively to the preparation of drugs. 
Since that time, the two professions of the physician and apothe- 
cary have been more or less divided ; though in new countries, 
and in remote situations where the population is not dense, and 
not collected in large towns, it still happens that necessity fre- 
quently unites them in the same individual. Mantias, a pupil 
of the famous Herophilus of Alexandria, enjoys the credit of 
having composed the first pharmacopoeia. 

The treatise of Celsus "De medicina," written during the 
reign of Augustus, and the most classical of the Latin medical 
works, though not devoted especially to the materia medica, 
gives the names of numerous medicines, with occasional brief 
accounts of their properties and applications, and a long cata- 
logue of recipes. Though richer in pharmacological information 
than any previous work now extant, it is yet very meager and 
indefinite. The reader seeks in vain for detailed and accurate 
description ; and the formulas given are mostly for external reme- 



HISTORY OF MATERIA MEDICA. 61 

dies, which are as poor in virtues as they are rich in the number 
of ingredients. 

The work of Scribonius Largus " Upon the Composition of 
Medicines" was written soon after that of Celsus, to which it is 
greatly inferior in style, without being superior in its pharma- 
cology. 

The two authors mentioned treated of medicines only inci- 
dentally, or in relation to their pharmaceutical preparation. 
Dioscorides may be considered as having composed the first 
regular treatise exclusively on materia medica. This celebrated 
medical writer was a Greek of Cilicia, in Asia Minor, and is sup- 
posed to have flourished in the reign of Nero. He treated, under 
distinct heads, of the plants and animals remedially employed, 
of the composition and use of medicines, of counter-poisons, and 
of venomous animals. Not less than 600 plants are mentioned 
or described by Dioscorides, showing that our science had already 
become grievously burdened, far beyond the abilities of her young 
shoulders to support. His descriptions have all the imperfections 
of the unscientific methods of his age; so that few comparatively 
of the plants which he mentions can now be recognized, and 
endless controversies have arisen as to their identity with those 
at present known. His pharmacy and therapeutics are not less 
defective. How could it have been otherwise, when botany was 
not yet a science, chemistry was altogether unknown, and 
anatomy and physiology had scarcely burst the shell in which 
the rudiments of their future growth lay enveloped? These 
sciences are the basis of medicine. How then could a durable 
structure be erected without them ? All that could be ex- 
pected of an ancient writer on medicines was to lay up a stock 
of materials for future hands to put together. This was done 
by Dioscorides beyond any preceding author. His work, viewed 
in relation to the times when he wrote, was a great work, though 
in relation to the present nearly worthless. 



62 HISTORY OF MATERIA MEDICA. 

The Natural History of the elder Pliny, who wrote at Rome 
somewhat after the time of Dioscorides, contains notices of 
numerous medical products; but, as he was not a physician, 
most of what he says upon this subject was borrowed from the 
writings of his predecessors. 

We next come to Galen, perhaps the greatest medical name 
among the ancients, at least the one which has exerted most in- 
fluence upon succeeding times. Had we lived four centuries ago, 
and ventured to doubt the infallibility of that name, we should 
have incurred the risk of being deemed suitable objects for the 
pillory or the mad-house. There can be no doubt that this 
author had great powers and great merit. But his influence 
over after ages rested more upon the time at which he wrote, 
than upon the excellence of what he wrote. Born at Pergamus, 
in Asia Minor, in the year 130 of our era, and dying about the 
close of the second century, he lived at a time when the human 
powers, mental as well as physical, had, in the progress of 
ancient civilization, begun to exhibit the decrepitude of age. 
The period was fast approaching when man ceased to have the 
energy of independent thought, and leaned exclusively upon the 
strength of the past. The Roman Empire propped up her phy- 
sical decay by the uncorrupted bodily vigour of the neighbour- 
ing barbarians, whom she incorporated in her armies. No such 
resource existed for mental deficiency. The accumulations of 
former ages were the sole reliance of the feeble senility of the 
Empire, as well as of the mental infancy of the centuries which 
succeeded its fall. Galen had great industry and powers of ob- 
servation, with a strong inventive and imaginative faculty. Out 
of the materials which lay scattered in the works of preceding 
authors, with no little aid from his own vigorous fancy, he 
erected a system of medicine which was faultless in the eyes of 
his contemporaries, and, standing prominently on that great 
elevation which looked over thirteen centuries of declension or 



HISTORY OF MATERIA MEDICA. 63 

barbarism, loomed magnificently to succeeding ages, and only 
began to grow dim when the light of reviving letters and science 
once more shone upon Europe. At present, it has fallen into 
utter ruin ; and the wonder is that a structure with so little of 
the solidity of truth, and so much of the pasteboard-work and 
colouring of mere imagination, should have so long withstood 
the ravages of time. When I tell you that, according to the 
theory of Galen, medicines have only the four primary properties 
of heat, cold, moisture, and dryness, and differ from each other 
only as they possess, or in the degree to which they possess, one, 
or another, or some combination of these properties, you will 
join me in admiring the simplicity which could receive so sheer 
an assumption for irrefragable truth. But thus it was received ; 
and, from the commencement of the third down to the sixteenth 
century, it would have been deemed as heretical to doubt the 
four qualities of Galen, as the equally absurd fiction of the four 
elements — fire, air, earth, and water. As nothing was detracted 
from the theory of Galen during this long period, so little was 
added to his facts. Indeed, for a great portion of the time, 
Western Europe lay almost in the darkness of barbarism ; and, 
so far from any improvement upon the ancients being made, 
only some feeble phosphorescent glimmerings of science con- 
tinued to shine, here and there, about the musty remnants of 
antique learning, preserved in the convent libraries. 

In the East, however, a new fountain of human energy had 
broken forth, which spread widely over the civilized world, and 
everywhere recalled a certain degree of fertility to the parched 
desert of the intellect. The successors of Mahomed no sooner 
found themselves securely seated in Bagdad, than they sought to 
beautify the rough edifice of their power with the ornaments of 
science. With the Syrian and African dominions of the Eastern 
Empire, the Arabians had seized also the treasures of Grecian 
learning, which they made available by recasting them into their 



64 HISTORY OF MATERIA MEDICA. 

own language. Medicine, as one of the most useful of the sci- 
ences, received a particular attention. The chief writers upon 
materia medica were the younger Serapion, the younger Mesue, 
Rhazes, Avicenna, Haly Abbas, and Albucasis. What they 
wrote, however, was chiefly borrowed from the Greeks. A few 
medicines, indigenous in their own country, or brought from the 
neighbouring regions of the East with which they had commercial 
intercourse, appear to have been either newly introduced by them 
into use, or at least were first made known, through their instru- 
mentality, to modern times. The first notices of senna and nux 
vomica are to be found in the writings of the Arabians. They 
cultivated pharmacy with especial zeal, and enjoy the credit of 
having laid the foundation of chemical science. There is reason 
to believe that they were acquainted with some mineral prepara- 
tions, wholly unknown to the ancients. Rhazes speaks of a 
preparation of mercury ; and it is highly probable that they were 
not altogether ignorant of the antimonials. 

The enlightened spirit which characterized the Arabians of the 
East was carried also into Spain by its Mahomedan conquerors; 
and schools of medicine were established in the cities of Toledo, 
Murcia, and especially Cordova, which continued in existence 
until the subversion of the Moorish power in the fifteenth 
century. 

It was, indeed, through the Arabians that the knowledge of 
ancient medicine began to be revived in Western Europe. The 
medical school of Salerno, in the south of Italy, which is said to 
have been established in the ninth, and continued to exist in the 
thirteenth century, owed its foundation and support to individuals 
who had been educated in Mahomedan countries. Many of the 
Crusaders who, in the East, had exchanged their religious enthu- 
siasm for admiration of Arabic science and civilization, and 
acquired a knowledge of the Arabic language, must have carried 
their new attainments back with them into Europe, and become 



HISTORY OF MATERIA MEDICA. 65 

centres here and there of a feeble illumination amidst the deep 
general darkness. The Moorish schools, moreover, in the south 
of Spain, were frequented by individuals from the Christian 
countries of the North, who contributed to spread still further 
the second-hand knowledge of the Arabians. The leaven, thus 
introduced into various parts of Christian Europe, began to pro- 
duce a slow working of the general mind, which required only 
the infusion of more abundant material to result in the most 
vigorous action. Such material was now poured in from the 
East, in consequence of the capture of Constantinople by the 
Turks in 1453, and the expatriation of all that remained of learn- 
ing and science among the degenerate Greeks. The fugitives, 
scattered over Europe, and especially over Italy, sought a liveli- 
hood by teaching Greek, and thus afforded access to the riches 
of ancient knowledge stored away in that language. The works 
of the Grecian writers were also translated into Latin, and, by 
means of the art of printing, then recently discovered, were ren- 
dered accessible to all who had any pretension to learning in 
those days. 

As, in the corporeal frame, excitability accumulates during 
sleep, so the long death-like repose of the human mind appears 
to have endowed it with renewed vigour ; and the materials 
which, in the hands of the worn-out Greeks, lay useless for the 
want of power to employ them, were eagerly seized b}^ the 
awakened spirit of the West, and wrought upon with all the 
energy of youthful ambition and enterprise. Medicine received 
its full share of attention. It was soon found that the knowledge, 
obtained from the Arabian authors, was but an imperfect ab- 
stract of that now open in the writings of the ancient Greek 
physicians, and especially in those of Galen. The works of this 
author were considered as oracles. In the intensity of the pre- 
vailing appetite, everything which they contained was received 
and devoured without scruple or selection ; pure speculation, 

5 



66 HISTORY OF MATERIA MEDICA. 

crude assertion, absurdities of all kinds, as well as sound reason 
and truth. 

But this could not last forever. The intellectual hunger was 
at length appeased. In many minds, satiety took the place of 
the first keen relish; new sources of excitement were demanded ; 
and inquiry began to extend itself beyond the limits of authority. 
The remedies of the ancients were derived chiefly from the vege- 
table kingdom 5 and the few of mineral origin employed, were 
applied for the most part to ulcers and other external affections. 
The Arabians had originated a taste for chemical research. This, 
it is true, was directed towards the discovery of the philosopher's 
stone and the elixir of life, the former of which was to convert 
everything into gold, the latter to protract human existence to a 
thousand years. But the operations of the Alchemists brought 
to light numerous mineral compounds, which, though incapable 
of lengthening the natural span of life, were found useful in the 
relief of disease. The insurrectionists against authority seized 
upon these new instruments, and wielded them with a senseless 
and indiscriminate vigour. Isaac of Holland and Basil Yalentine 
maintained that salt, sulphur, and mercury were the true ele- 
ments of things. A work ascribed to the latter, under the name 
of "Currus triumphalis Antimonii," set forth the merits of the 
antimonials in extravagant terms. The bold, eccentric, and 
visionary Paracelsus, armed with mercury, antimony, and opium, 
and clothed with an impenetrable mail of impudence, ran a vig- 
orous tilt at once against disease and old opinions, and roused 
the attention of all Europe to his feats. Yan Helmont followed 
with a more enlightened defence of chemical medicine. The 
advocates of the ancients struggled manfully against these inno- 
vations ; and a fierce contest arose between the Galenists on the 
one side, and the Chemists on the other, which continued not 
less than a century. The latter ridiculed the inertness of the 
Galenical simples ; the former inveighed in unmeasured language 



HISTORY OF MATERIA MEDICA. 67 

against the murderous violence of the chemical preparations. 
The depositories of political power sympathized with the sup- 
porters of authority in medicine ; and at one time the use of 
chemical remedies was forbidden in France under heavy penal- 
ties. Common sense, however, at last prevailed; and physicians 
felt themselves at liberty to use efficacious means wherever they 
might be found. The materia medica was thus enriched by the 
addition of numerous metallic and saline preparations, some of 
which are at the present day considered among the most valuable 
of our remedies. 

About the same period, important accessions to the materia 
medica began to be received through the channel of geographical 
discovery. The traders to India, by the Cape of Good Hope, 
brought various hitherto unknown medicinal products from the 
remote East, and rendered abundant in the markets of Europe 
others which had before reached the West, in small quantities, 
through the expensive route of Arabian and Venetian commerce. 
The discovery of America, too, laid open a vast field, which has 
not yet been completely explored or exhausted. Everything is 
said to be gigantic on this continent; our plains, our rivers, our 
mountains ; we may add also our diseases and our remedies. 
For thousands of years the giant strength of Peruvian bark had 
been slumbering in the Andes. It was now awakened ; and 
diseases which, since the creation, had been stalking, almost 
unresisted, with a desolating march over the earth, shrunk into 
insignificance before its beneficent power. Ipecacuanha, jalap, 
copaiba, sarsaparilla, guaiac, and logwood were also among the 
numerous contributions made by this continent to the general, 
materia medica. 

Up to the seventeenth century, the condition of our science 
was that of progressive accumulation. Remedy was added to 
remedy ; the whole materia medica of Greece and Rome, swollen 
by Arabian contribution, was poured into the lap of modern 



68 HISTORY OP MATERIA MEDICA. 

Europe; and art and nature were ransacked to increase the 
already vast and ill-assorted mass. There were gems in this 
mass ; but they only sparkled here and there amid the rubbish 
in which they were embedded. It may be instructive to throw 
a glance backward, and mark some of the sources of the useless 
materials which thus loaded the materia medica. 

In the first place, many substances inferior in virtues, or com- 
bining some noxious property with that for which they were 
originally used, though superseded by the discovery of others 
more efficient and less objectionable, were retained from habit, 
the weight of authority, the affectation of science, or the difficulty, 
in the irrational therapeutics of the times, of conclusively ascer- 
taining their real relative efficiency. 

Again, we now know well that most diseases will in the end, 
as a general rule, terminate favourably without medicines, and 
not unfrequently even in spite of medicines. One not properly 
instructed on this point, seeing recoveries taking place under his 
treatment, naturally ascribes the result to his medicines, though 
a closer observation, a more prolonged experience, or a better 
judgment might afterwards convince him that they were in fact 
useless, or worse than useless. Here has been at all times, and 
still continues to be, the stronghold of quackery, and of all other 
forms of irregular and irrational practice. "My patients get 
well," says the old woman, and the Indian Doctor, and the man 
of nostrums and panaceas, and the homceopathist, and the 
hydropathist, and the whole host of irregular prescribers, through 
all their ramifications of ignorance, self-deception, cunning, and 
impudent fraud. " My patients get well," say these pretenders ; 
and so thev often do. But it is because nature is wiser and kinder 
than the prescriber, who nevertheless ignorantly or unscrupu- 
lously ascribes to his nostrum all the credit of the cure. Such 
was the origin of a large proportion of the inert medicines, which 
crowded the catalogues of the older pharmacopoeias. 



HISTORY OF MATERIA MEDICA. GO 

But there was another abundant source of the same evil. 
Men had yet not learned the wonderful influence of mental 
operations over the bodily functions in health and disease. 
They had not observed how often disorders, especially those 
seated in the nervous system, give way before powerful emo- 
tions, or any strong excitement of the rational or imaginative 
faculty. In full faith they gave their inert medicaments ; in full 
faith their patients received them ; and, without irreverent allu- 
sion, faith in medicine is able to remove mountains. It is well 
known that the cure of intermittent diseases is often effected by 
exciting in the mind of the patient a firm belief that he will miss 
the paroxysm. The substance employed may have been wholly 
inert; but it is nevertheless believed to have produced the 
result, and takes its rank in the materia me.dica. 

But if, along with faith, some other strong mental agency be 
called into operation ; the mysterious, the fearful, the horrible, 
the disgusting ; anything that makes one shudder, the effect is 
vastlv increased. Hence, in old times, the bones of executed 

J 7 7 

criminals, the moss growing on a dead man's scull, animal excre- 
ment, toads, and snakes, and disgusting insects, and all sorts of 
venomous beasts, were supposed to possess curative powers, and 
therefore found a place in pharmacological catalogues. So com- 
mon was this, that the apothecary did not think his shop fur- 
nished, unless he had in his windows a goodly show of bottled 
snakes and lizards. The web of spiders is even now considered 
an efficacious remedy by some practitioners ; and dried vipers 
are retained, as one of the ingredients of the Theriac, in the last 
edition of the French Codex. 

Another somewhat analogous source of inert medicines existed 
in the singular doctrine of signatures, which supposed a thera- 
peutical relation between substances endowed with certain sen- 
sible properties of colour, taste, and shape, and the diseases of 
organs in which these same properties were found or imagined. 



70 HISTORY OF MATERIA MEDIC A. 

Thus the euphrasia or eyebright was deemed efficacious in oph- 
thalmic complaints, because its corolla bore a fancied resemblance 
to the eye ; hepatica, in disorders of the liver, because its leaves 
were somewhat like that organ in colour ; turmeric, in jaundice, 
because it was yellow ; dragon's blood, in hemorrhage, because 
it was red ; and mandrake, in barrenness and deficient virility, 
from a supposed resemblance of its bifurcated root to the thighs 
and body of a man. 

But, besides these material incumbrances, the materia medica 
was burdened, if anything so unsubstantial can be said to be a 
burden, with a vast number of purely imaginary influences; some 
springing from mere superstition, some from erroneous science, 
some from the wildest vagaries of an excited fancy, which, not 
yet schooled in the strict philosophy of Bacon, and living in the 
midst of a world of mystery, viewed nothing as absurd or im- 
possible which did not involve a self-evident contradiction. Not 
to speak of the healing powers ascribed to this or another shrine, 
to saintly relics, to priestly exorcisms, and to all those analogous 
means which selfish art has suggested to the misguided devo- 
tional tendencies of our nature ; there were the influences of the 
sun, moon, and stars ; of magic, sorcery, and witchcraft ; of for- 
tunate times, and fortunate numbers ; of charms, and spells ; of 
the royal touch, and of innumerable conjunctures of circumstance, 
to which accidental coincidence, false observation, or a bewil- 
dered fancy had attached the notion of positive efficiency. Many 
of these vagaries, though banished from science, still find a refuge 
in vulgar ignorance, and the credulity of childhood. Who among 
you. has not heard of that infallible cure for sties, which consists 
in the patient standing in the middle of two crossing roads, and 
repeating that erudite couplet, 

" Sty, sty, leave my eye, 
And take the first person that passes by?" 

Who does not know that red flannel is infinitely more efficacious 



HISTORY OP MATERIA MEDICA. 71 

than white, and that a red string about the neck is a certain pre- 
servative against numerous distempers ? I would not undertake 
to affirm, that some of us now present have not, in our childish 
days, worn a little bag of brimstone about the person, to secure 
it against a rather vulgar infection from our school companions. 
We may wonder that all these absurdities could ever have en- 
tered into the creed of the cultivated and the learned ; but, when 
we see who and what many of those persons in our day are, who 
believe in clairvoyance and other extravagances of animal mag- 
netism, and what numbers of distinguished persons, male and 
female, but especially the latter, swallow with a charmingly in- 
fantile faith and simplicity the millionth of a grain of silex, or 
some other equally powerful homoeopathic medicine, and believe 
themselves cured ; our wonder at the past may well be exchanged 
for a feeling of deep humility, at the real feebleness of the much- 
boasted human intellect. 

A new era in our science commenced with the eighteenth cen- 
tury. The inductive system of philosophy passed, it is true, very 
slowly into medicine. In relation to the functions of our system, 
in health and disease, so much is unknown as to afford an irre- 
sistible temptation to the speculative spirit, which loves to expa- 
tiate in the misty obscure, where no stumbling-blocks of fact lie 
in the way of its weakness, and no torch of truth shines upon 
its defects. It was not till within our own times that this spirit 
of hypothesis yielded to that of investigation ; and it still occu- 
pies many an intellectual stronghold, from which it is not likely 
to be expelled so long as the sports of fancy are found less 
fatiguing than the labours of research. Yet the general current 
of human thought has, since the days of Bacon, set so strongly 
into the channel of strict induction, that our science could not 
but feel its influence in some degree ; and, though the materia 
medica has more or less followed the devious flights of medical 
theory, yet the claims of individual substances, whether of old 



72 HISTORY OF MATERIA MEDICA. 

or recent origin, to a place in its ranks, have been examined with 
much greater care, and admitted with much greater caution than 
formerly. The consequence has been that a vast number of inert 
articles have been discarded, and all those, which owed their 
introduction to the vagaries of a deranged imagination, have 
been swept away, if not from officinal catalogues, at least from 
general use. 

The unitarian theory of medicine, which recognized no other 
deviation from health than the exaltation of the vital actions 
above, and their depression below the normal standard, and con- 
sequently no other power in medicines than a stimulant or seda- 
tive property, had a tendency greatly to diminish the number of 
substances employed, and co-operated with the new-born common 
sense of the profession in clearing away the Augean accumula- 
tions of preceding ages ; one of the constantly recurring exam- 
ples of that order of Providence, which deduces ultimate good 
out of present evil. 

Two other agencies operated very efficiently both in reducing 
the materia medica within narrower limits, and in giving a greater 
degree of precision, order, and consistency to the remaining mate- 
rials. These were the sciences of botany and chemistry, which, 
though their seeds had been planted and begun to germinate in 
earlier times, had not pushed up into a characteristic growth until 
after the commencement of the last century. Botany proved 
useful by giving precision to the description of medicinal plants, 
thereby preventing the confounding of one with another, which 
had previously been a great source of error. It also served to 
concentrate the materia medica by leading to the observation of 
analogous therapeutical properties in certain families of plants, 
and thus suggesting the probable inefficiency of substances, de- 
rived from any particular plant of an inert family. It may even 
in the same way have tended to confirm the accuracy, or correct 
the errors of observation, in relation to efficacious medicines ; 



HISTORY OF MATERIA MEDIC A. 73 

as the reputed virtues of a plant might be considered as real or 
suspicions, according as they did or did not conform with the 
characteristic properties of the family to which it belonged. 

Chemistry has been still more beneficial in its influence. Even 
in its infancy it won for medicine many rich prizes from the do- 
main of nature, and has continued to yield it new and valuable 
accessions even down to our own times. Witness iodine and its 
combinations, which have been added to the materia medica since 
the commencement of the present century. But its usefulness 
has been experienced even more in the selection, preparation, and 
various combination of the raw material than in its collection. 
Teaching the intimate nature of bodies, it afforded the means not 
unfrequently of ascertaining their relative value, of choosing the 
best out of a number having similar properties, and of sifting 
the useful from a mass of the worthless or injurious. By making 
known the relations and reciprocal actions of bodies, it originated 
or improved processes for their preparation, detected impurities 
and substitutions whether fraudulent or accidental, and enabled 
the prescriber to avoid all the hurtful consequences of incompati- 
ble admixture. Through its instrumentality, a precision before 
wholly unattainable has been introduced into all pharmaceutical 
operations. Another most important service, which it has ren- 
dered to pharmacology, is the discovery of the active principles 
of vegetable medicines, and the isolation of these principles for 
practical use ; so that we have all the power of the original 
medicine without its uncertainty, and without the embarrassment 
of the inert or noxious matter contained in it. The art of ex- 
tracting quinia from Peruvian bark, which is a pure result of 
chemical research, is one of the greatest blessings which science 
has conferred on man. If France has destroyed her millions by 
the sword, she has also saved her millions by this great discovery. 
How infinitely preferable are these peaceful and beneficent tri- 
umphs of science to all the bloody trophies of ambition ! I 



74 HISTORY OF MATERIA MEDIC A. 

would rather, with Pelletier and Caventou, have been the dis- 
coverer of quinia, than to have shared the gory honours of Napo- 
leon, exalted as he was in genius, intellect, and energy of will 
almost above humanity. 

Under the influences above enumerated, materia medica has, 
within the last century and a half, assumed a definite and con- 
sistent form. It has risen from the state of embryotic chaos into 
the matured dignity of science. The pharmacology of our times 
bears to that of the sixteenth and seventeenth centuries the rela- 
tion which a regular disciplined army, with its due proportion 
of foot, horse, and artillery, well furnished, well officered, and 
well commanded, bears to the vastly superior numbers of an 
Asiatic host, with several non-combatants for each fighting man, 
without order, without obedience, a mere armed rabble, which 
breaks to pieces in its own onset, and shatters under the first 
blow. How much more effectively, then, are we prepared than our 
ancestors to sustain the encounter with disease : to guard against 
its frequent ambushes, to conquer its strongholds ! Could the 
times of antiquity return, and a single tyro in modern materia 
medica be left, of all the present world, among the sages of the 
past, the hoary heads of Galen and Hippocrates would bow at 
his footstool, and Greece and Rome would hail him as a god. 

It remains for us, in order to close this very general sketch, 
to offer a brief account of the several departments of pharma- 
cology as at present existing, and to name a few of the most 
distinguished modern writers. 

The first division of the science is that wli'ch considers the 
source of medicines, in other words, the minerals, plants, and 
animals which yield them. This is denominated medical natural 
history, of which by far the most copious branch is that which 
treats of plants alone, or medical botany. The next division is 
the history of simple drugs, which embraces a description of 
medicinal substances as they are placed by commerce in the 



HISTORY OP MATERIA MEDICA. T5 

hands of the apothecary, including an account of the modes of 
collecting* and transmitting them to market, and a statement of 
their sensible, physical, and chemical properties. The science 
next follows the drug into the shop or laboratory, and, under the 
name of pharmacy, teaches the mode of preparing it for use, 
together with its characters and relations with other bodies 
when thus prepared. Lastly, the effects of the medicine upon 
the healthy and unhealthy system, its applications to the cure 
of disease, and the modes of administering it, constitute the sub- 
jects of another and most important department, that, namely, of 
therapeutics. Toxicology, or the history of poisons, may also 
be considered as forming a division of pharmacology; for most 
poisonous bodies are nothing more than medicines in a high 
grade of action ; and the substances calculated to obviate their 
morbid effects are clearly entitled to a place in the materia medica. 
These several subjects, however, are seldom entirely distinct in 
practical treatises, which often embrace two or more, or even 
the whole of the departments, and, when ostensibly confined to 
one, frequently step over its boundaries into a neighbouring 
province. 

The writers of the middle ages, being few, and mere copyists 
of the ancients, do not merit a particular notice. Among those 
of the sixteenth and seventeenth centuries w T ere several whose 
names are still held in respect, though their works are scarcely 
ever consulted, except by the curious. Such were Tragus, Ta- 
bernsemontanus, Csesalpinus, Bauhin, Pison, and Margraf, who 
wrote upon medicinal plants ; Basil Yalentine, Paracelsus, and 
Glauber, who directed their attention especially to chemical reme- 
dies ; and Schroeder and Hoffman, who treated of medicines in 
general. Of the authors of the last 150 years, who have written 
upon pharmacology in one or more of its branches, the most dis- 
tinguished are, in Sweden, Linnaeus and Bergius ; in Germany, 
Cartheuser, Murray of Gottingen, Yogel, Plenk, Sprengel, 



76 HISTORY OP MATERIA MEDICA. 

Trommsdovff, Hayne, Nees von Esenbeck, Bucholz, Brandes, 
Geiger, and Richter ; in France, Lemery, Tournefort, Chomel, 
Baurne, Alibert, Vivey, Guibourt, Chevallier, Richard, Fee, 
Henry, Ratier, Soubeiran, Orfila, Merat, De Lens, Trousseau, 
and Pedoux ; in England, Lewis, Woodville, Cullen, the two 
Duncans, Murray of Edinburgh, Paris, Thomson, Brande, Chris- 
tison, and Pereira. Of these, Chomel, Plenk, Woodville, Hayne, 
Richard, and Nees von Esenbeck treated especially of medical 
botany; Lemery, Guibourt, Fee, and Geiger, of the history of 
drugs ; Baume, Brandes, Henry, Ratier, Soubeiran, and Brande, 
of pharmacy; Orfila and Christison, of poisons; the remainder, 
of the subject of materia medica in general. I do not speak of 
the writers of this country, because, in a previous introductory 
lecture, I treated at large of the history of the materia medica 
within the United States, and, on that occasion, endeavoured to 
do justice to those who had, by their writings or otherwise, con- 
tributed to the advancement of our science on this side of the 
Atlantic* 

I am aware that, in the list of European authors just given, 
many have been omitted, some, perhaps, as much entitled to dis- 
tinction as those mentioned. I am aware also that a mere 
enumeration of their names is but a very meager satisfaction, 
either of their just claims, or your proper curiosity; but time is 
wanting for a fuller consideration of the subject in this place ; 
and opportunity will frequently be offered hereafter, when upon 
the subject of particular medicines, to give due credit to those 
who have deserved well of the science by their contribution of 
material, fact, or useful reflection. 

* Though the lecture here referred to preceded, in the order of delivery, 
that which is now occupying the attention of the reader ; yet, in the rela- 
tion of subject-matter, it should obviously take a subordinate position ; 
and I have accordingly placed it second in the series. 



HISTORY OF MATERIA MEDICA. ?7 

I have thus, gentlemen, introduced the materia medica to your 
notice. You will find it altogether worthy of your acquaintance, 
and may be assured that it will repay abundantly your most 
solicitous cultivation. True, it does not possess many charms 
for the careless eye. The recollections of boyhood, when the 
nauseous draught was forced by parental anxiety down your 
reluctant throat, are altogether against it. The very odour of 
the drug-shop naturally indisposes to a close association with 
the drugs themselves. The nature of the science, moreover, is 
so manifold, that a laborious attention is necessary even to a 
moderate intimacy. But when you come to know it well, you 
will rejoice that you overcame the first feeling of disinclination. 
You will find it a true friend in your time of heed, aiding you in 
your daily encounters with disease, inspiring confidence, and 
offering means of relief, when there would be no hope without 
it ; and, where you cannot save, enabling you to smooth the way 
of the departing, and to shed comfort on the last hour. You 
will, therefore, gentlemen, I kn-ow, honour my introduction ; you 
will give your best regards and your best efforts to the science ; 
and I shall be happy to stand by, encouraging your zeal, and 
assisting your labours to the utmost of my ability. 



LECTURE II. 

DELIVERED NOVEMBER 3rd, 1840. 



History of Materia Medica in the United States. 

Allow me, gentlemen, before proceeding to the peculiar duties 
of the occasion, to greet heartily my old friends among you, and 
to those who are here for the first time to proffer my kindest re- 
gards, while I ask for theirs in return. It is always my desire, 
when entering with the class upon our mutual labours for the 
winter, that we should go hand in hand together. Not only is 
the way thus rendered more agreeable both to teacher and pupil ; 
but they are also enabled to advance more rapidly; as the intel- 
lect always operates with greater efficiency when aided by the 
affections. That head must be empty indeed which the heart 
cannot stimulate into action. The consciousness that he pos- 
sesses the good will of his class is to the lecturer one of the most 
powerful incentives to exertion ; and instruction seldom fails to 
sink deeply into the learner, when he feels that it proceeds as 
much from interest in his welfare as from a sense of duty. Let 
us, therefore, gentlemen, set out as friends upon our contemplated 
journey. You will find me disposed to do everything, during its 
course, which will contribute to leave us friends at the end of it. 

I have selected, as the subject of this introductory discourse, 
the history of the materia medica in the United States. In this 
choice, I do not wish to be considered as actuated by any narrow 
(W) 



HISTORY OF MATERIA MEDICA IN THE U. STATES. 79 

preference of the discoveries or improvements, made in our own 
country, over those of foreign origin. Our patriotic partialities 
have been appealed to in favour of American medicine, in con- 
tradistinction to that of the old continent. But this is folly, or 
something worse. Medicine is a science, and science is truth 
brought to light. Now, truth is one everywhere. She is of no 
place or country. Wherever she may be brought forth, from the 
moment of her birth, she belongs equally to the whole world. 
She brooks no individual or national fetters ; but is the common 
friend and servant of mankind. To speak of an American truth 
would be absurd. Would it be less so to speak of American 
medicinej as something distinct from the general science ? But, 
though it becomes us to throw aside that impolitic self-conceit 
of patriotism which undervalues whatever comes from abroad, 
and stigmatizes with the ancient Greeks and modern Chinese 
everything foreign as barbarous, we may justly and profitably 
endeavour to estimate the amount of truth which our country 
has contributed to the general mass, and thereby stimulate a 
generous emulation to augmented efforts, either to supply de- 
ficiency, or to achieve or maintain an honourable precedence in 
the race of improvement. This is all that I purpose in calling 
your attention to the materia medica of the United States. 

In treating of this subject, I propose, first, to give a general 
view of the medicines which our country has furnished to the 
world, and of the resources she contains within herself; secondly, 
to speak of the condition of this department of medical science, 
and of the individuals who have contributed to its promotion 
within our limits ; and thirdly, to offer you some inducements to 
exertion in the development of our yet hidden, or but partially 
discovered treasures. 

If we extend our view to the whole American continent, we 
have to boast, on this side of the Atlantic, of medicinal resources 
inferior probably to those of no other section of the globe. Not 



80 history or materia medica in the r. states. 

to mention numerous substances of little importance, we have, 
in the Peruvian bark, the most valuable of all tonic medicines, 
scarcely indeed suq^assed in efficiency and extent of application 
by any other article of the materia medica ; in the qnassia of 
Surinam and the West Indies, the strongest of the pure vegetable 
bitters ; in the rhatany of Peru, one of the most efficient astrin- 
gents ; in the ipecacuanha of Brazil, the best of all vegetable 
emetics : in the jalap of Mexico, the best vegetable hydragogue 
cathartic ; in the balsam of Tolu. a good stimulant expectorant : 
and finally, in copaiba, and guaiac. and sarsaparilla. medicines 
of peculiar and valuable properties, such as could not well be 
dispensed with in the practice of our art, and could not be re- 
placed elsewhere. But none of these substances are found in 
the United States : at least none of them are furnished to com- 
merce by the soil of our country. 

It is. indeed, singular, considering the extent of our territory, 
the diversity of its climate, and the vast number of its vegetable 
productions, that so few medicines from this source have been 
admitted into the European catalogues of materia medica, or 
even come into general use among our own practitioners. When 
I have mentioned lobelia, sassafras, seneka, serpentaria, spigelia. 
toxicodendron or poison oak, and the Canada and common white 
turpentines. I should be at a loss to add the name of another 
medicine, procured exclusively from the territory of the United 
States, or north of it, which has been introduced to any con- 
siderable extent into European practice. It is true that there 
are several medicinal plants common to Xorth America and the 
old continent : such as the bitter-sweet, dandelion, hop, Iceland 
moss, juniper, pipsissewa, thorn-apple, and uva ursi. But, even 
with this addition, the catalogue of our indigenous medicines 
recognized abroad is very meager ; and it is a question of some 
interest, how it happens that so great a disproportion exists 
between the extent of our country and its contributions to the 



HISTORY OF MATERIA MEDICA IN THE U. STATES. 81 

general materia medica. It is not that our native resources, in 
this respect, are peculiarly deficient. On the contrary, as I shall 
soon have occasion to show, the United States are rich in indi- 
genous medicinal products. But there is a coincidence in prop- 
erties, real or supposed, between the old standard medicines and 
many of those of native origin, which has caused them to be 
applied to the same states of disease ; so that the substitution of 
the latter for the former could yield no advantage sufficient to 
overbalance the influence of habit in practitioners, their natural 
want of confidence in untried means, and the various facilities 
for prescription, afforded them by a regular supply of the drug 
through established commercial routes, and long-settled modes 
of pharmaceutical management. Labour, moreover, in this 
country is too costly to compete with that which supplies most of 
the foreign drugs. We wield the various means of profit on too 
large a scale, and are too much accustomed to the floods of gain 
which pour in from vast fields of labour and enterprise, to pay 
much regard to those dribblets that accrue from the collection 
of barks and roots. Hence, the supply of our indigenous medi- 
cines is not such as to enable them, upon considerations of 
economy, to displace those already in use of equal or better 
understood virtues ; and the consequence is that the general de- 
mand for them is confined to substances of peculiar properties, 
such as could not be elsewhere procured. The influence of our 
national habits of labour upon the commercial value of drugs, 
is strikingly illustrated in the very great increase in price of 
spigelia or pink-root, since the emigration of the Cherokee In- 
dians, by whom chiefly it was in former times collected and sent 
to market. 

I have said that the United States are rich in medicinal pro- 
ducts. This will be rendered obvious by running the eye over 
a list of the more important indigenous medicines, classified 
according to their effects upon the system. Under the head of 

6 



82 HISTORY OP MATERIA MEDIC A IN THE U. STATES. 

astringents, we shall find the bark of different species of oak; the 
roots of the blackberry, dewberry, Geranium maculatum, and 
Heuchera Americana or alum-root ; and the leaves of the pipsis- 
sewa and uva ursi. Among these are medicines capable of 
being employed for any object attainable by means of the class 
to which they belong, at least of the portion of it derived from 
the vegetable kingdom. In tonics our country is very rich. It 
is true that we have no cinchona ; but, in the barks of the differ- 
ent species of cornus or dogwood, we have remedies analogous, 
though inferior to it in virtues. Of the simple bitters, sabbatia, 
coptis, and xanthorrhiza might be substituted for gentian, quassia, 
and columbo. The union of various important properties with 
the purely tonic, as those of a stimulant in serpentaria, of a nar- 
cotic in hops, of a sedative in wild-cherry bark, of a diaphoretic 
and emetic in boneset, renders these medicines of great value; 
and those of them not hitherto introduced into the universal 
materia medica, highly deserve to be so. I consider wild-cherry 
bark as among the most efficient remedies in the tuberculous 
diathesis, and not inferior to any other medicine in the treatment 
of consumption itself.* Our catalogue of aromatics is also 
copious, including, among others, angelica, calamus, sassafras, 
hedeoma or pennyroyal, common marjoram, partridge-berry, 
and spice-wood or laurus benzoin. Of stimulants we have tur- 
pentine and its volatile oil ; of narcotics, stramonium and dul- 
camara; of antispasmodics, dracontium and cimicifuga. Our 
emetics, if we leave ipecacuanha out of the question, are inferior 
to those of no other country. Lobelia, though so much abused 
by empirics, is possessed of highly valuable properties ; gillenia 
is supposed to resemble the famous Brazilian root in its action ; 
and sanguinaria conjoins with its emetic properties others of a 

* This was written before the introduction of cod-liver oil ; and with 
this exception, I consider the remark as still holding true. 



HISTORY OP MATERIA MEDICA IN THE U. STATES. 83 

peculiar nature, which are thought to render it especially useful 
in certain forms of disease. Among the cathartics, we have 
substitutes for several of those imported, as in cassia mari- 
landica for senna, in extract of butternut for rhubarb, and in 
podophyllum for jalap. We are not wanting in diaphoretics or 
diuretics, and as an expectorant our seneka holds, in my estima- 
tion, the very highest rank. As epispastics we have several 
species of Cantharis not inferior in virtues to the Spanish fly ; 
and the Cantharis Nuttalli of the far West may some time come 
into extensive use, as it is said to be abundant, and has the ad- 
vantage of equalling if it does not exceed the foreign insect in 
magnitude. Our native turpentine and its volatile oil, together 
with hemlock pitch, are good rubefacients; slippery-elm bark is 
an excellent demulcent and emollient; and perhaps in no part 
of the world are there vegetable anthelmintics more efficacious 
than spigelia and chenopodium. In this enumeration I have not 
attempted to exhaust the whole catalogue of native medicines. 
My object was only to show that our resources are ample, by 
calling attention to the more prominent of those substances the 
virtues of which are known. Besides those mentioned, there 
are many others which have been more or less investigated ; and 
I have no doubt that some yet lie buried in the mass of our lux- 
uriant vegetation, which will one day be brought to light, to the 
honour of their discoverers, and the benefit of mankind.* 

More than fifty years ago, the opinion was advanced by 
Shoepf that, relying upon their native resources, the Americans 
might dispense with the greater part, if not the whole, of the 

* Since this lecture was delivered, Veratrum viride or American hel- 
lebore, and Leptandra, have acquired a reputation, the former as a seda- 
tive, the latter as a cholagogue cathartic, which, had it then existed, 
would have insured their admission into the above list. The common 
poke-root, Phytolacca decandra, has considerable reputation as an alter- 
ative cathartic. 



84 HISTORY OP MATERIA MEDIC A IN THE U. STATES. 

imported medicines. Even at the present time, however, with 
all the improvement which half a century has conferred upon 
our indigenous materia medica, I cannot coincide wholly in this 
sentiment. The present standard remedies are for the most part 
those which have stood the test of ages. They have been 
gathered from all quarters of the globe, have gone through every 
variety of trial, and have been sifted out from an immense mass 
of materials, which had been for thousands of years in the course 
of accumulation. Happy the country which can boast itself the 
source of one of the more important of these remedies ! It will 
hold a place in the memory of mankind so long as human in- 
firmity shall exist, and, even with no other claims upon our 
sympathies, will rank among the valued spots of the earth, when 
countries which derive their importance from mere temporary 
causes shall have been forgotten. The whole human family 
will ever look to the region of the Andes with interest, as the 
source of Peruvian bark, even though the political clouds which 
now overshadow her shall deepen into tenfold darkness, and her 
moral culture become as desolate as her own icy summits. It 
is not in the order of Providence to lavish on any one country a 
wealth, equal to that scattered over the whole world beside. 
Not even the microscopic eye of patriotism could magnify our 
medicinal riches into competition with those of the entire globe. 
They are, however, very ample ; and, should political accident 
ever cut off our supply of drugs from abroad, though the want 
of them would certainly be severely felt, we should nevertheless 
be able, in the products of our own soil, to find partial substi- 
tutes for almost all that we had lost. It becomes us most care- 
fully to cultivate our resources, both that we may be fully pre- 
pared against whatever adverse events may occur, and in the 
hope, moreover, that we may thereby add something new and 
valuable to the means already existing for the alleviation of 
human evil. 



HISTORY OF MATERIA MEDICA IN THE U. STATES. 85 

It is an interesting subject of inquiry, in what manner attention 
was first attracted to the medicinal plants of this country. When 
our ancestors had established themselves in their new home, and 
began to investigate with the eye of curiosity or interest the 
various novelties around them, it was natural that they should 
at once be struck with resemblances to familiar objects, and 
should expect a similarity in properties where they found a sim- 
ilarity in appearance. The care of their health no doubt early 
directed their inquiries towards medicinal products; and plants, 
resembling the simples with which they had been familiar, re- 
ceived corresponding names and similar applications. Thus we 
have our centaury, our dittany, our hellebore, our pennyroyal, 
our senna, our worm-seed, and numerous others so closely allied 
to the European plants by botanical affinities as to be entitled to 
the same generic designation, such as the elder, the elm, the oak, 
the pine, and the willow. In this way a domestic materia med- 
ica was immediately commenced, which gradually increased as 
substances before unknown were accidentally, or from the pos- 
session of certain striking sensible properties, submitted to trial, 
and found or imagined to operate usefully as medicines. Several 
substances were also derived from the aborigines, of which the 
most important are seneka, serpentaria, and spigelia. 

It was at one time a general belief that the Indians were in 
possession of many valuable remedies, and had even specifics for 
various obstinate complaints which had baffled European skill. 
These they were supposed to keep secret from some mysterious 
cause, which acted powerfully on the popular faith by exciting 
the imagination. A class of empirics took advantage of this 
superstition, and, under the name of Indian Doctors, spread 
themselves over the country, imposing their nostrums upon the 
public credulity as secrets obtained from the aborigines, and 
decrying, with all the zeal of the Thompsonians who have suc- 
ceeded them, the poisonous minerals employed by the regular 



86 HISTORY OF MATERIA MEDICA IN THE U. STATES. 

practitioners. But faith in the superior medical knowledge of 
our savage tribes is disappearing with the tribes themselves. 
The simple truth seems to be, that many of the indigenous medi- 
cal plants were known and employed, though very unskilfully, 
by the Indians, who communicated all they knew to the Eu- 
ropeans upon their settlement in the country. Whatever mystery 
may have, in some instances, been thrown over the subject, was 
a contrivance of imposture to conceal its real ignorance, or to 
magnify, through the effect of partial obscurity, its little grain 
of knowledge into something worthy of notice. 

The wants of the country during the war of independence, 
when the supply of drugs as well as other necessaries from 
abroad was very much impeded, stimulated attention to our 
indigenous resources, and led, if not to the discovery, at least to 
a fuller investigation and more extensive use of various native 
medicines. 

Another circumstance which contributed very considerably to 
the cultivation of our native materia medica was the regulation, 
formerly existing in this school, which required the publication of 
the inaugural dissertations of the graduates. A laudable regard 
to their reputation stimulated the exertions of the candidates, 
many of whom were induced to extend their researches into the 
yet but very partially explored region of our native medicines, 
and were rewarded by discoveries either of new substances, or 
of new and valuable properties in those already known. 

It is due to those who have aided in bringing a fresh soil of 
knowledge into culture, that their names and services should 
from time to time be revived in the memory of their successors, 
who are enjoying the fruits of their labours. It is, besides, a 
healthy excitant of our own exertions, thus to have placed before 
us the example of useful effort, and its just reward of commenda- 
tion. An account, therefore, of the earlier writers upon our 
indigenous materia medica may be justly expected from a teacher 



HISTORY OF MATERIA MEDICA IN THE U. STATES. 87 

of that science, addressing those who are to be at once the de- 
positaries of the reputation of their predecessors, and claimants 
of a like office from posterity towards themselves. I wish to 
make the proposed sketch as full as the occasion will permit ; 
but it will be necessarily inadequate, and should be filled up by 
your own further research. 

The earliest notices which I have been able to discover of 
North American medicinal plants are those contained in tLe 
Flora Tirginica of Dr. John Clayton, published at Leyden by 
Gronovius in 1739. Dr. Clayton was a native of England, but 
emigrated early in life to Yirginia, where he became eminent as 
a naturalist and physician, and died in 1773, at the very advanced 
age of 88 years. Dr. Thacher states that he published, in the 
Philosophical Transactions, an ample account of the medicinal 
plants which he had discovered. It is his name, I presume, 
that has been enshrined in the botanical designation of that 
beautiful little spring flower, the Glaytonia Virginica. 

In the years 1743 and 1744, similar medico-botanical notices 
of plants, growing in the province of New York, were published 
in the Upsal Transactions by Dr. Cadwallader Colden, a gentle- 
man of considerable scientific and political distinction, who came 
from Great Britain to this country about the year 1710, and 
established himself in that province. 

But, perhaps, the most ample of these earlier contributions 
was that by John Bartram, a native, I believe, of Pennsylvania, 
who was distinguished as an indefatigable cultivator of botany, 
and is very favourably remembered in this city as the founder 
of the botanical garden upon the Schuylkill, which has always 
gone by his name, and is still in the hands of one of his descend- 
ants.* His essay, containing a description of several medicinal 

* This splendid botanical garden has subsequently passed into other 
hands, and is now greatly deteriorated, if, indeed, it retains at all its 
, original character. 



88 HISTORY OF MATERIA MEDICA IN THE U. STATES. 

plants of North America, was printed in the year 1756, in the 
Amoenitates Acadeniieae of Linnaeus, as' a portion of a paper 
denominated Specijica Canadensium, prepared by John Ton 
Colin, and intended to embrace what was at that time known in 
relation to the materia medica of this country. 

In subsequent years, various additions were incidentally made 
to the store of knowledge by writers upon other subjects, as by 
Catesby in his Natural History of Carolina, and by Kalin, a 
Swedish gentleman, who travelled in North America about the 
middle of the last century, and published an Itinerary on his 
return to Europe. 

The first work devoted expressly to the materia medica of 
North America was that of Dr. Shoepf, a German physician, 
who came with the Hessian troops to this country during the 
revolutionary war, and remained for some years after its termi- 
nation, travelling through the different States, and giving an 
especial attention to the study of plants. After returning to 
Europe, he published, at Erlangen, in Germany, a treatise in the 
Latin language, under the title of Materia Medica Americana, 
describing with scientific brevity a great number of our indige- 
nous and naturalized plants, with the shortest possible account 
of their sensible properties, effects on the system, and medical 
uses. His work, however, can be of little use to the practitioner ; 
for, though he has introduced everything into it with an indis- 
criminating eagerness, his practical remarks are exceedingly 
vague, meager, and unsatisfactory ; and even the dose and proper 
mode of administration are, for the most part, withheld. 

A much more valuable practical essay was that of Doctor 
Benjamin Smith Barton, formerly professor of materia medica, 
and afterwards of the practice of medicine in this University, 
whose various knowledge, zeal in the prosecution of natural his- 
tory, and talents as a medical teacher are still fresh in the recol- 
lection of the profession. No one man in the United States, I 



HISTORY OF MATERIA MED1CA IN THE U. STATES. 89 

presume, has contributed so much to the improvement of our 
native materia medica. Not only did he diffuse by his writings 
aud lectures the knowledge which he had accumulated by dili- 
gent research, but he breathed a spirit of investigation into the 
young men who heard him, that produced a rich result of dis- 
covery. The work referred to lays no claim to the consideration 
of a regular treatise, being modestly entitled " Collections for an 
Essay towards the Materia Medica of the United States," and 
consisting of materials partly gathered from previous writers, 
partly accruing from his own inquiries and observations, and 
thrown together without any great attempt at elaboration. His 
aim appears to have been to collect into a single repository, of 
convenient access, facts which might otherwise have been lost, 
or, from their scattered condition, have remained inaccessible to 
ordinary research. His book has been a storehouse of materials 
for subsequent authors, and will probably continue to be at the 
fountain-head of inquiry; as it contains all that an investigation 
pushed into the times beyond it would be likely to discover. It 
consists of two parts, the first of which was published in 1198, 
and afterwards with some additions in 1801 ; while the second 
part did not make its appearance till 1804. 

It would be impossible for me, consistently with my present 
design, to mention individually the numerous inaugural essays 
and monographs published in the journals, in relation to par- 
ticular indigenous medicines. Many of these have considerable 
merit, and some have been the means of introducing to general 
notice valuable remedies, which have since retained a place in 
the public esteem. It was soon after the appearance of Dr. 
Barton's Collections, that the attention of students of medicine 
appears to have been most strongly directed into this channel ; 
for in the year 1802, not less than six theses on the subject of 
our medicinal plants were published by alumni of this school, 
though the whole number of graduates of that year did not 
exceed twenty. 



90 HISTORY OF MATERIA MEDICA IN THE U. STATES. 

I do not know that it is strictly in keeping with the plan of 
this lecture to call attention particularly to the botanical works, 
which appeared about this time and subsequently, and which, 
though they did not make the medicinal virtues of plants a 
special object, nevertheless contain scattered notices in relation 
to them, of some value to the physician and medical writer. It 
may, perhaps, be sufficient to mention the Xorth American Flora 
of the elder Michaax, which was printed at Paris in 1803, and 
that of Frederic Pursh, who, after having been diligently engaged 
for more than twelve years in exploring the botany of this country, 
either by personal examination of the plants in their localities, 
or by means of the herbariums of others, published at London, 
in 1814, his very valuable work. 

There is another author whom it would not be just to pass 
over, without some allusion to his merits in connection with our 
subject. I refer to the younger Michaax, whose treatise on the 
forest-trees of Xorth America, written in French, and published 
at Paris in 1812, was soon afterwards translated by Mr. Hill- 
house into English, and printed at the same place. This is a 
splendid work, containing a great number of beautiful illustrative 
engravings, and embodying a vast deal of information in relation 
to our forest-trees, which, though it bears more especially upon 
commercial and agricultural interests, is yet, in many instances, 
of considerable value in a medical point of view. 

We have now come to the period of contemporary writers, in 
relation to whom prudence would recommend silence ; as praise, 
though deserved, might to over-delicate ears sound like adula- 
tion, and censure might be ascribed to envy or the ill-will of 
opposite interests. Yet if we yield to this squeamish delicacy 
on the one hand, and to the fear of derogatory imputations on 
the other, we deprive merit of its best reward ; the knowledge, 
namely, that it is justly appreciated ; while impertinent ignorance 
is allowed to strut about with impunity, and impose its fooleries 



HISTORY OF MATERIA MEDICA IN THE U. STATES. 91 

or knavery upon modest simplicity as truth. I scarcely know 
why I should preface by these generalities the introduction to 
your notice of two works, which, from an American pen, deserve 
nothing- but praise, and the character of which is so well estab- 
lished, that no commendation which I might bestow upon them 
would be ascribed to other motives than a sense of justice and 
patriotic pride. I confess, gentlemen, that I do feel some pride 
in naming to you the Medical Botany of Dr. Wm. P. C. Barton 
of Philadelphia, and the American Medical Botany of Dr. Jacob 
Bigelow of Boston ; not that these productions offer a claim to 
the highest rank as works of science or art, but that, considering 
the materials at command, the state of the arts among us, and 
the meager patronage they were likely to receive, the enterprise, 
industry, zeal, and, I may say, success with which they were 
executed, and the great advance which they exhibit beyond 
whatever previously existed here, are calculated to do honour 
to all of us as fellow-countrymen of their authors. The design 
of their execution appears to have been nearly simultaneously 
conceived, and they were both published in the year 181 7. They 
consist of descriptions, somewhat ample, of our medicinal plants 
in all their interesting relations, with coloured engravings of 
these plants, and all sorts of references. It might be invidious 
to discriminate between them ; but if I were to venture an 
opinion of their relative merits, I should give the palm decidedly 
to the Philadelphia work upon the score of art and elegance of 
execution, while that of the Boston professor might well dispute 
the precedence on the score of science and research. They have 
conjointly placed our native materia medica on a much higher 
footing than it stood upon before ; and nothing has been subse- 
quently published which could have the least tendency to throw 
them into shade.* 

* The date at which this lecture was delivered must be borne in mind 
by the reader. 



92 HISTORY OP MATERIA MEDICA IN THE U. STATES. 

To bring our hasty review down to the present time, we have 
only to allude to the facts, that, in the various treatises upon 
the general subjects of materia medica and pharmacy which have 
been published in this country, our own medicines have received 
their share of attention ; and that articles have occasionally ap- 
peared in the medical journals, either containing new facts, or 
presenting what was before known in a new light. 

There is, however, one circumstance connected with our present 
subject, which it would be improper to pass over wholly without 
notice ; I allude to the chemical analysis of many indigenous 
medicines, which has resulted in a much more accurate knowledge 
of their composition, and a juster view of their pharmaceutical 
relations than previously existed. The particular results have 
been consigned to the journals, and cannot of course be men- 
tioned here ; but such of them as are of practical value to the 
physician will be noticed under the heads of the several medicines 
in my lectures. We are indebted for them chiefly to graduates 
of the Philadelphia College of Pharmacy, which appears to have 
afforded to its students, in their particular pursuit, a stimulus 
similar to that which our own school, at a period of its history 
already referred to, imparted to the candidates for its honours. 

In no part of the United States, perhaps, has our indigenous 
materia medica been practically cultivated to the same extent 
as in New England, and particularly in Connecticut. Several 
medicines of native origin are, I am told, habitually employed by 
the regular practitioners, which are little if at all used elsewhere ; 
and Professors Ives and Tully, who have successively lectured 
on materia medica in the Medical Department of Yale College, 
are said to have offered to the student a minuteness and variety 
of information upon the physiological effects and therapeutical 
uses of those medicines, which would be in vain sought for in 
books. It is to be hoped that the present professor may some 
time consent to share with his medical brethren in general his 



HISTORY OF MATERIA MEDICA IN THE U. STATES. 93 

peculiar knowledge; for it must be confessed that there is 
nothing in which we are more deficient, than in the accuracy 
and precision of our acquaintance with the virtues of most of our 
indigenous medicines.* 

It is worthy of mention, in connection with this subject, that 
particular attention has been paid to the collection and prepara- 
tion of indigenous plants by the Shakers, who furnish, indeed, 
to the shops most of their supplies, and generally in the best 
condition. An extensive business of this kind is carried on by 
the Shakers of Lebanon, in New York; and, during a recent 
journey in Ohio, I found that at their settlement in that State 
they w r ere cultivating the same source of profit. 

Our view has hitherto been confined to the state of materia 
medica, in relation to the objects of that science furnished exclu- 
sively by this country; we are now to consider the history and 
condition of the science in its general relations among us. A 
few words will embrace all that need be said on this subject ; 
for the history of materia medica in the United States has been, 
till within a few years, identical with that of the same branch 
of knowledge in Europe. While we were colonies of England, 
we were willingly indebted to the mother country for intellectual 
supplies, as well as for manufactures, and, considering our credit 
as involved in hers, did not seek an independent national repu- 
tation. Our medical doctrines and modes of practice, the choice 
of remedies and their modes of preparation, even the medicines 
themselves and all their pharmaceutical modifications, were 
received from Great Britain with a filial respect, which did not 
allow us to suspect the possibility of anything better, or more 

* It is scarcely necessary to inform the reader that Dr. Wm. Tully, 
alluded to in the text, recently died, while engaged in an elaborate work 
on materia medica, of which two volumes had issued from the press at 
the time of his decease. — Note to the first edition. 



94 HISTORY OP MATERIA MEDICA IN THE U. STATES. 

applicable to our condition. Her authorities were our authori- 
ties, her books were our books, and in great measure her phy- 
sicians were our physicians ; for the great West was then the 
Atlantic border, and the young medical men from the mother 
country found a welcome as cordial as that now extended, on the 
banks of the Mississippi, to the alumni of our own schools. Nor 
did our professional cease with our political dependence. For 
many years after we had thrown off the yoke of the mother 
country, we continued to look to her authors almost exclusively 
as our guides in medicine. So far as concerns the materia medica, 
the first effort to supply ourselves was in the publication, in 1806, 
of the American Dispensatory by Dr. John Redman Coxe. This 
work was little more than a reprint of the Edinburgh Dispensa- 
tory, with an alteration in the arrangement of the articles, and 
the introduction of some notices in relation to our indigenous 
medicines. Such as it was, however, it acquired great celebrity, 
passed through numerous editions, and, for many years, was the 
almost exclusive pharmaceutical guide-book of a great portion 
of the Union. In 1810, appeared the American New Dispensa- 
tory by Dr. James Thacher, of Massachusetts, which, with 
greater claims to originality, was scarcely less meritorious in 
other respects than its predecessor, and had the advantage of 
presenting more elaborate and better digested accounts of our 
native medicines than had yet appeared in any one work. This 
soon divided with Dr. Coxe's book the patronage of the country, 
circulating more especially in the Eastern States, though it also 
penetrated into a few shops and libraries in the more Southern 
sections. 

In the year 1817, a new era in the history of our science in 
America commenced with the publication of Dr. Chapman's work 
on Therapeutics and Materia Medica. Hitherto we had done 
little more than add to the products of the European press our 
peculiar knowledge in relation to indigenous medicines. Dr. 



HISTORY OF MATERIA MEDICA IN THE U. STATES. 95 

Chapman took a bolder flight; and, by the publication of a sys- 
tematic and original treatise, containing elaborate doctrine, 
interesting practical views, and highly important therapeutical 
facts of a general character, placed us at once upon a footing 
with English authorship in this department of medicine. If his 
work be considered rather in reference to the physiological 
effects, or practical application of medicines, than to their 
history as objects of physical science or pharmaceutical man- 
agement, though, as they who have attended my lectures well 
know, I cannot coincide in all the opinions which it advo- 
cates, I can with sincerity say that I know of nothing superior 
or equal to it, among the treatises on materia medica in the 
English language, existing at the time when it was written. 
The work of Dr. Chapman was followed, in 1822, by the Materia 
Medica of Dr. Bigelow, and, in 1825, by the Materia Medica and 
Therapeutics of Dr. Eberle. The former was intended as a 
sequel to the Pharmacopoeia of the United States, of which it 
may be considered as an explanatory commentary, without 
claiming to rank as a finished treatise upon the science. The 
latter is an elaborate work, prepared with great industry and 
research, and containing much very valuable information. I 
should not be doing justice to the student without recommending 
to him, especially in the intervals of his winter labours, the 
diligent perusal of Dr. Chapman's and Dr. Eberle's treatises. 

Of the work which came next in the order of time it does not 
become me to speak, except in the most general terms. The 
United States Dispensatory, which has been adopted as the text- 
book of the ensuing course of lectures, made its first appearance 
in 1833. I may, perhaps, be permitted to say of that portion of 
the work executed by my friend, Dr. Bache, which concerns for 
the most part the chemical articles, that it is marked by all the 
scrupulous accuracy, precision, and faithfulness, which so favour- 
ably characterize the author in all his relations. 



96 HISTORY OF MATERIA MEDICA IN THE U. STATES. 

To complete the list of American works upon materia medica, 
it remains only to mention the " ISTew Remedies" of my friend 
and co-labourer in this field of medicine, Dr. Dunglison, which 
was published in 1839. This is a valuable treatise, containing 
much information in relation to new or little employed remedies, 
and might advantageously lie on the table of every practitioner, 
with a view to occasional reference.* 

* Since the year 1840, many other works on materia medica and phar- 
macy have heen given to the world by American writers. The Medical 
Formulary of Dr Benjamin Ellis, published in 1826, and the work on 
Baths and Mineral Waters, by Dr. John Bell, first published in 1831, 
should have been noticed in the text. The following is the list, with the 
dates of publication, so far as the author has ascertained, of those which 
have appeared subsequently to 1840: Dictionary of Materia Medica, on 
the basis of Brande, by John Bell, M.D., 1841 ; General Therapeutics and 
Materia Medica r \>j Kobley Dunglison, M.D., 1843; Elements of Materia 
Medica and Therapeuiics , by John P. Harrison, M.D., 1845; Adulteration 
of various Substances used in Medicine and the Arts, by Lewis C. Beck, 
M.D., 1846; Illustrations of Medical Botany, by Jos. Carson, M.D., a 
splendid work in two large quarto volumes, 1847 ; Medical Botany, by K. 
Eglesfeld Griffith, M.D., 1847; Materia Medica and Therapeutics, by 
Martyn Paine, M.D., 1848; Catalogue of the Medical Plants of New York, 
by Charles A. Lee, M.D., 1848; Essay on Infant Therapeutics, by John 
B. Beck, M.D., 1849; Chemical and Pharmaceutical Manipulations, by 
Messrs. C. Morfit and A. Muckle, 1849 ; Materia Medica and Thera- 
peutics, by Thos. D. Mitchell, M.D., 1850; A Universal Formulary, by 
R. Eglesfeld Griffith, M.D., 1850 ; Lectures on Materia Medica and Thera- 
peutics, a posthumous work, by John B. Beck, M.D., edited by C. R. 
Gilman, M.D., 1851; Synopsis of the Course of Lectures on Materia 
Medica and Pharmacy, in the University of Pennsylvania, by Joseph 
Carson, M.D., 1851 ; Outlines of a Course of Lectures on Materia Medica, 
in the Medical College of South Carolina, by Henry E. Frost, M.D., 
1851 ; Review of Materia Medica, for the Use of Students, by John B. 
Biddle, M.D , 1852; Mineral and Thermal Springs of the United States 
and Canada, by John Bell, M.D., 1855; Introduction to Practical Phar- 



HISTORY OF MATERIA MEDICA IN THE U. STATES. 97. 

Having seen what has been written upon the subject of which 
we are treating, we are naturally led to the inquiry, what has 



maty, by Mr. Edward Parrish, 1856; Treatise on Therapeutics and 
Pharmacology, by the author, 1856 ; and Rational Therapeutics, by 
Worthington Hooker, M.D., 1857. The unfinished work of the late Dr. 
Wm Tally has been referred to in a former note ; and a Treatise on 
Materia Medica and Therapeutics, by Alfred Stille, M.D., is announced 
as in the press.* Besides the publications above mentioned, valuable 
additions have been made by their American editors to various foreign 
works on materia medica and pharmacy, reprinted in this country. 
Without attempting to enumerate all these, I would call attention to the 
Additions to Mohr and Redwood' 's Treatise on Pharmacy, by Prof. "Wm. 
Procter, Jr., and those of Prof. Jos. Carson, M.D., to the excellent work 
of Dr. Pereira on Materia Medica. 

It would be unpardonable, in a catalogue of American contributions 
to materia medica and pharmacy, to pass without notice the American 
Journal of Pharmacy. Commenced, with the title of Journal of the Phila- 
delphia College of Pharmacy, in the year 1825, under the auspices of the 
College, it was suspended, after the issue of a few numbers, until the year 
1829, when it was resumed, under the same auspices; and from that date 
it has continued uninterruptedly to the present time, having, in the year 
1835, taken the more appropriate title of the American Journal of Phar- 
macy. The editors, who have always been aided by a publishing com- 
mittee of the College, have been, successively, Dr. Benjamin Ellis from 
1829 to his death in 1831, Dr. K. E. Griffith from 1831 to 1837, Dr. 
Jos. Carson from 1837 to 1850, and Prof. Wm. Procter, who followed 
after the resignation of Prof. Carson. f This journal has contributed 
largely, at all times, to the progress of pharmacy in the United 
States, and is at present by far the best pharmaceutical periodical with 
which the author is acquainted, in the English language. Another 
pharmaceutical journal, entitled New York Journal of Pharmacy, was 



* I need not say that this work met with distinguished success, and is now, January, 1872, 
among the standard works on Materia Medica. — Note to the second edition. 

f Professor Procter having retired from the editorship of the American Journal of Phar- 
macy, it has passed into the hands of Professor John M. Maisch. — Note to the second edition. 



98 HISTORY OF MATERIA MEDICA IN THE U. STATES. 

been done or discovered, in this country, towards the advance- 
ment or improvement of the science of materia medica, inde- 
pendently of the additions it has received from our indigenous 
products. The amount of our contributions in this way is not 
large. Most medicines have been so long subjected to all sorts 
of trial, in every variety of disease, that to fall upon a really 
new physiological property, or therapeutical application, is a 
rare occurrence; and even where an individual may imagine 
that he has made some interesting or important discovery, the 
chances are great that it is a long known and recorded fact, of 
which he was ignorant from deficient means of information. In 
the short annals, therefore, of our independent medical history, 
we are to look for very few improvements of the kind alluded 
to. Still, by running our eye over the medical journals, we 
shall find that our soil has not been entirely barren. From 
among the great mass of suggestion and reported experience, a 
few facts might be picked out here and there which have the 
stamp of novelty. You will observe that I am now speaking of 
the general materia medica, exclusive of that which is the pe- 
culiar product of our native vegetation, and in which our contri- 
butions have been ample. To mention each individual case, in 
which an old medicine may have received a new application at 
our hands, would be out of place on this occasion. Such notices 
belong to the special history of medicines, and will be introduced 

published in the city of New York, in the year 1852, but was suspended 
after a short continuance ; and a third, now in existence, is published in 
Baltimore, under the name of Journal and Transactions of the Maryland 
College of Pharmacy, and bids fair to maintain a highly respectable 
position among the journals of the country. The American Pharma- 
ceutical Association has also published annually, for the last seven years, 
a volume of its Proceedings ; and the volume giving the proceedings for 
the year 1858 contains much matter of interest to the medical as well as 
the pharmaceutical profession. — Note to the first edition, Dec. 1859. 



HISTORY OF MATERIA MEDICA IN THE U. STATES. 99 

into ray lectures under appropriate heads. There have, how- 
ever, been two discoveries by American physicians which merit 
particular notice; as they have been the means of introducing, 
out of the mass of materials everywhere accessible, new and 
effective remedies into general use. One of these discoveries, 
made by Dr. John Redman Coxe, was of the existence of virtues, 
analogous to those of opium, in the inspissated milky juice of the 
common lettuce, which has consequently found a place in the 
officinal catalogues, both here and in Europe, under the name of 
lactucarium; the other, due to Dr. Stearns, of the State of New 
York, was of the peculiar and highly important properties in 
ergot, which have led to its universal adoption as an article of 
the materia medica,* 

There yet remains another point of view, from which to con- 
sider the materia medica of the United States. In every civil- 
ized country of Europe, it has been considered indispensable, in 
order to a due regulation of the nomenclature and preparation 
of medicines, to establish a system of rules, which should have 
the sanction of law. Without the uniformity resulting from such 
pharmaceutical codes, no physician could depend on obtaining 
from the apothecary the same medicine or preparation, under the 
same name, and infinite confusion, with its consequent mischief, 
would result. These codes are put forth, under the title of phar- 
macopoeias, by colleges or other authorized bodies, and, having 
the sanction of the government, constitute a part of the public 
law. Thus, the pharmacy of England is regulated by the Lon- 
don College of Physicians through their pharmacopoeia, that of 

* In this connection, it is proper to refer to ethereal inhalation, as an 
anaesthetic in surgery, first brought into notice by Dr. Morton, of Boston, 
and to the employment of collodion for its adhesive qualities, which is due 
to Dr. Maynard, also of Boston ; both of which are discoveries of 
American origin, and the first, perhaps the most important which has 
been made, in this department of medicine, since the discovery of quinia. 



100 HISTORY OP MATERIA MEDICA IN THE U. STATES. 

Scotland in like manner by the Edinburgh College, and that of 
Ireland by the Dublin College.* In this country we were long 
without any such generally recognized code ; and the prepara- 
tions were made according to the directions of one or another of 
the British Colleges, at the discretion of the apothecary, or even 
according to some favourite recipe of his own ; so that com- 
pounded medicines of the same title were often entirely different 
in different sections of the country, and even in different shops of 
the same town. The first effort to remedy this evil, of which I 
have any knowledge, was made in 1&08 by the Medical Society 
of Massachusetts, by which measures were taken for the prepa- 
ration of a pharmacopoeia, which was published, and was after- 
wards adopted by the Medical Society of New Hampshire. But 
no general movement took place till about the beginning of the 
year 1820, when a convention of physicians from various parts 
of the country met at Washington, and framed a pharmacopoeia, 
which was intended to express the sentiments of the profession 
throughout the Union, and thus to acquire an authority which 
we have not the means of conferring- on such a work bv law. 
It was denominated the Pharmacopoeia of the United States, 



* In consequence of an act of the British parliament, regulating, in 
some degree, the medical profession in Great Britain and Ireland, the 
three pharmacopoeias hitherto recognized are to be consolidated into one ; 
and a committee, under the auspices of the general Medical Council, 
which may be considered as the representative of the whole profession in 
the British Islands, is at this moment engaged in preparing a pharmaco- 
poeia, which is hereafter to he the sole standard for the empire.* If no 
other good than this shall result from the recent movements of the med- 
ical profession in England, all the time, trouble, and expense which they 
have cost, will be far overpaid. — Note to the first edition, Dec. 1859. 



* This has been published, and has eTen gone through a second revision'; and is now the 
only recognized code within the bounds of the British empire. — Xote to the present edition, 
Jan. 1672. 



HISTORY OF MATERIA MEDICA IN THE U. STATES. 101 

and was received, to a considerable extent, as the pharmaceuti- 
cal standard of the country ; but its many defects and errors, 
such as are incident to a new undertaking, and especially to one 
in which numerous irresponsible hands are engaged, prevented 
its universal acceptance. Provision, however, had been made 
for the supply of these deficiencies by a revision at the end of 
ten years. Accordingly, in January, 1830, a second convention 
met at Washington, by whose authority a revised and very much 
amended edition was published. This has been subsequently 
admitted by the country in general as an authoritative pharma- 
ceutical code, though in the absence of any legal sanction, it has 
not been altogether sufficient to restrain propensities to inde- 
pendent action on the part of individuals. In order to render 
the work still more worthy of the place which it claims to occupy, 
as well as to bring it up to the present level of our knowledge, 
a third convention, which met at the commencement of the 
present year in Washington, provided for another revision, to 
the aid of which the colleges of pharmacy were invited, so that 
the practical and peculiar skill of the apothecary might be brought 
into co-operation with the knowledge of the physician. This 
aid has been secured ; and the pharmacopoeia has been submitted 
to a thorough examination, which it is hoped will end in such 
an improvement as to render it generally if not universally 
acceptable.* 

* The revised pharmacopoeia was published in 1842 ; and another revi- 
sion, under the auspices of a convention which met at Washington in 
1850, issued from the press in 1851. A fifth convention is to meet at the 
same place in May next, which will submit the work to another decen- 
nial revision.* By the careful scrutiny to which the pharmacopoeia is ex- 



* This revision was followed by another and very thorough one in 1860 ; and, at the usual 
decennial convention in 1870, provision was made for still another; aud the revised work is 
now ready for the press. — Note to the second edition, Jan. 1872. 



102 HISTORY OF MATERIA MEDICA IN THE TJ. STATES. 

I have alluded to the pharmaceutical colleges. It is not in- 
appropriate to the occasion to state, that these institutions — of 
which one has been in efficient operation in Philadelphia since 
the year 1822, and another, subsequently founded, is now in 
operation in New York — have contributed very greatly to im- 
prove the art of preparing medicines in this country, and, by 
elevating the profession of pharmacy, have rendered it a much 
more efficient auxiliary to ours. The late convention at Wash- 
ington has, I think, merited well of the country in inviting the 
co-operation of these colleges in an important national work, 
in which both professions are equally interested, and which 
can scarcely be satisfactorily completed unless by their joint 
labours.* 

And now, gentlemen, having conveyed you through a brief 
history of the materia medica in this country, will you allow me 
to urge upon you the application of your own efforts to the im- 
provement of this branch of medicine, and especially of that 
portion of it which concerns our indigenous products ? I know 
no fairer field for you than this, in which to gain a name for 
yourselves, or accomplish something useful to your profession. 
Success would be doubly grateful to a patriotic spirit ; for, while 
your country would share in the honour which might accrue to 
one of her sons, she would enjoy the advantage also of a culti- 
vation of her own peculiar resources. Can I not paint to your 

posed at this regular interval of ten years, the opportunity is afforded 
of correcting its errors, and supplying its deficiencies ; so that it is ren- 
dered a just expression of the knowledge of the times, and has come to 
be almost universally acknowledged as a legitimate standard for the 
country. — Note to the first edition, Dec. 1859. 

* Besides the Philadelphia and New York Colleges, referred to in the 
text, another has "been since established, and is in full operation in Balti- 
more ; and, as I have been informed, a third has been organized in 
Chicago. — Note to the first edition. Dec. 1859. 



HISTORY OP MATERIA MEDICA IN THE U. STATES. 103 

fancy a prospect which will rouse all your energies to realize it? 
Suppose that, by a careful and laborious investigation, by a long 
course of varied experiment and accurate observation, you have 
arrived at the discovery of some valuable medicine hitherto con- 
cealed in the wilds of our country, or of some yet unknown 
peculiarities and powers of a medicine already recognized. Your 
name is at once honourably known in connection with your dis- 
covery ; through life you will have the consciousness that you 
at least are not among those who pass undistinguished along 
their destined course, and leave no trace behind them ; your 
children and your children's children will inherit the imperisha- 
ble treasure of your reputation. In the pages upon which suc- 
ceeding generations of students will dwell, your name will be 
connected with the record of the good that you have accom- 
plished ; in the lectures to which future aspirants for medical 
honours will listen, your claims will not be forgotten when your 
discovery is alluded to ; perhaps from this very spot, some future 
professor, giving, as I have done to-day, a history of the materia 
medica of our country, may cite your example as an honour to the 
institution, and a powerful incentive to his pupils. It is some- 
thing also to possess the consciousness that you have added to 
the credit of your profession, and have been a benefactor to your 
country and to mankind. These, it is true, are motives of action 
common to every honourable field of exertion ; the peculiar in- 
ducements in that now offered to you are the deficiency of 
present culture, and the greater probability of a rich return for 
all the labour expended. Our native materia medica may be 
said to have lain fallow for several years. Pathology has by its 
fruitful yield drawn almost all floating labour to itself; and 
fashion has invested it with additional attractions. Our com- 
paratively neglected science has, in the mean time, through the 
progress of general discovery, been accumulating renewed fer- 
tility, and w T ill yield abundantly to properly directed culture. 



104 HISTORY OF MATERIA MEDICA IN THE U. STATES. 

May I not hope that some of you, under the inducements which I 
have presented, or others which your own minds may suggest, will 
engage heartily in this work of investigation, in the pursuit of 
the high prize of honour for yourselves, your school, your pro- 
fession, and your country ? 

But you must remember that such a prize is not easily won. 
We cannot guess ourselves, nor dream ourselves into honourable 
distinction. The pursuit of a creditable name is no lottery, in 
which the highest prize may be drawn by careless indolence, or 
self-satisfied ignorance. You must work, if you would gain the 
wages of labour. 

Having thus called you to exertion, I may very properly be 
required by you to point out the best plan of beginning and con- 
ducting your investigations. Your first object will be to select 
some particular subject of inquiry. You may choose some in- 
digenous plant, whose medicinal properties have already attracted 
the notice of the profession, but have not been thoroughly studied ; 
or you may search amidst the rubbish of popular and domestic 
practice, and find something perhaps of value which has hitherto 
lain concealed ; or, finally, you may examine the plants of our 
woods and meadows, and, guided by the odour, taste, or other 
obvious property indicating some power of affecting the human 
system, may perchance be led to the discovery of a useful and 
hitherto unknown medicine. I would recommend the first course ; 
as the catalogue of officinal or semi-officinal plants is already 
numerous, and it is desirable to sift this thoroughly before at- 
tempting to augment it. 

In the very beginning, you must take care to avoid the too 
common error of explorers, of determining at all events to find 
something new — a determination which is apt to deceive the 
fancy into the belief that it has discovered what it has in fact 
only invented. Let your search be after truth, and nothing but 
truth. It maybe as important to deprive a counterfeit medicine 



HISTORY OF MATERIA MEDICA IN THE U. STATES. 105 

of its false credit, as to add a new one, though genuine, to the 
mass of circulation. You will perform an important service, if 
you can prove satisfactorily that one of the received medicines 
is quite valueless. 

Having selected the subject of experiment, you are first to 
ascertain its effects upon the human system in health. Try it 
upon yourselves, upon your friends, upon persons of different 
sex, age, and temperament, beginning with doses which you 
know to be safe, and gradually increasing till its activity or inert- 
ness is evinced. Ascertain its influence upon the brain and 
nervous system, upon the stomach and bowels, upon the heart 
as indicated by the pulse, upon the temperature of the body, 
upon the secretions, and in fine upon all the healthy functions. 
Note all these effects carefully as you observe them ; but at the 
same time be very cautious not to confound those changes in the 
system which may result from mental influence, or from the 
operation of ordinary or accidental causes, with those which are 
the genuine product of the medicine. Do not be satisfied with 
a single trial in each case, but repeat it, with varying circum- 
stances, till there can no longer be a doubt of the actual effect 
produced. 

When you have sufficiently convinced yourselves of the 
efficiency of the medicine, and ascertained its peculiar physio- 
logical action, you are next to apply it to the treatment of dis- 
ease ; and here the same caution is requisite not to allow your- 
selves to be misguided by the influence of various disturbing 
agencies, nor to make hasty conclusions from one or a few trials. 
There is nothing in relation to which we are more apt to draw 
false inferences than the action of medicine in disease. Most 
complaints have a tendency to spontaneous cure, and will in 
general go on sooner or later to recovery, without the use, and 
often notwithstanding the use of medicine. In such cases, the 
last drug administered is apt to have the credit of the cure, 



106 HISTORY OF MATERIA MEDICA IN THE U. STATES. 

though all its operation may have been to protract this result. 
There are numerous causes which operate on the system in dis- 
ease, giving rise to changes not anticipated, which, without due 
caution, may be ascribed to the remedies employed. Against 
all these sources of error you must be on your guard, and above 
all against your own hopes, whieh will act powerfully in causing 
you to see things as you wish them. 

Other points which will require investigation are the part or 
parts of the plant most effective, its relations to the usual men- 
strua employed in pharmacy, as water and alcohol, the best mode 
of administration, and the dose. Its composition and general 
chemical relations are also important objects of inquiry; but few 
medical men, and none who have not devoted a special attention 
to practical chemistry, are capable of conducting successfully 
those complex and delicate processes which are essential to accu- 
rate analysis, especially of organic products. This part of the 
investigation may, therefore, with propriety, be left to the 
pharmaceutical chemist, within whose province it strictly falls. 

To complete your work, it will now only remain to record the 
results of your investigations. In doing this, your rule should 
be to put down everything exactly, plainly, and in as few words 
as possible consistently with perfect clearness. Your object will 
not be to produce an impression by means of rhetoric, but to 
establish facts in science ; and these are always most striking in 
their native simplicity. We suspect the purity of truth herself, 
when she is disguised in meretricious ornament. You should 
endeavour in your narrative to present to the reader, in their 
proper order, all the materials for forming a judgment of which 
you may be yourselves in possession, and thus enable him to 
come to the conclusion you desire, perfectly satisfied of its cor- 
rectness. No matter whether your inquiries have ended in the 
discovery of some new fact, or the refutation of some old error ; 
in either case the result is truth, and the process by which it was 



HISTORY OF MATERIA MEDICA IN THE U. STATES. 10T 

attained is equally deserving of record. But be not in haste to 
publish your essay after you have prepared it. An author is 
seldom a good judge of his own productions when immediately 
from his pen. He views his offspring with a paternal, I might, 
perhaps, be allowed to say, with a maternal eye, which can see 
no defects, and often finds beauties when indifference would 
discover only deformity. Lay aside your manuscript for a time ; 
let the ardour of composition cool, the pains of your mental 
labour be forgotten ; you will then be able to judge of your own 
production more as a critic than as an author; and you may 
depend upon it that you will find much to amend, and rejoice 
that you have yet the power. 

I have thus, gentlemen, accomplished the object which I pro- 
posed at the beginning of the lecture. Much more might have 
been said on almost every point, and perhaps not unprofitably, 
had time and space permitted ; but in this world of limited power 
and limited opportunities, one great secret of doing well is to 
take a just view of the power and opportunity we actually pos- 
sess, and adapt our aims and efforts accurately to them. This 
at least I endeavour to make a rule of action for myself; and you 
will find me governed by that rule in the subsequent course of 
lectures. We have only a certain amount of time allotted to 
materia medica. In arranging my course, I have endeavoured 
to find the just proportion between the importance of the several 
topics and the whole time, and to devote to each topic its due 
share of consideration, so that none may be entirely neglected. 
If I am thus induced to say less than lecturers often do upon 
certain prominent subjects, I have at least the advantage of 
giving some attention to others, which, though severally less 
important, are much more so in the aggregate. My great object 
is to give the pupil opportunities for acquiring such a knowledge 
of principles and facts, as may serve for a basis to his own future 
labours. To render these opportunities available, your zealous 



108 HISTORY OP MATERIA MEDICA IN THE U. STATES. 

co-operation will be requisite. Judging from the experience of 
the past, I have no doubt of such co-operation. I have not yet 
had occasion to complain of the want of due attention on the 
part of a class, and entertain no apprehension that, at the termi- 
nation of the present course, I shall have cause to express a 
different sentiment. Should my efforts equally content your 
reasonable wishes, my ambition will be satisfied. 



LECTURE III. 

DELIVERED NOVEMBER 5th, 1844. 



Importance of Materia Mcdica. 

Among those now present are many to whom everything 
around them is familiar. There are also many to whom the 
occasion, the place, and the speaker, are equally new. The 
former I count as friends already, and welcome them cordially 
and affectionately back to our old relations. The latter I hope 
to rank among my friends, when a short intercourse shall have 
made us mutually acquainted ; and, in the mean time, would 
extend to them my kindest greetings, with the assurance that I 
have sincerely at heart their best welfare in all respects. 

My present duty is to introduce, and recommend to your 
favourable attention, the study of materia medica. This depart- 
ment of medicine has been somewhat undervalued in later times. 
Pathology, in itself so copious, has been forced by peculiarly 
fostering influences into a luxuriance of growth, which has 
somewhat overshadowed the other branches of our science. 
Policy, moreover, has led to the representation of materia med- 
ica as inferior in practical importance, and scarcely worthy of 
any peculiar diligence either in teaching or learning it. This 
policy has, no doubt, coincided with honest convictions ; for the 
objects of our own individual pursuit swell, almost unavoidably, 
into a magnitude which throws all others into the shade. In 

(109) 



110 IMPORT AXCE OF MATERIA MEDICA. 

asserting and maintaining an opposite view, I may be accused 
of acting under similar influence. I admit the charge to a cer- 
tain extent; but there is this obvious difference, that, whatever 
may be my regard for the science which has constituted one of 
the chief objects of my life-long labour. I arrogate for it no 
superiority ; I claim for it only equality with its sister sciences. 
Upon this footing, gentlemen. I wish to place it in your estima- 
tion ; in order that your dispositions towards it may not be 
rendered lukewarm, nor your exertions in its cultivation slacken, 
under any false views which may have been, or may still be pre- 
sented to you. of its inferior relative value. 

The great object of the physician is to restore health to the 
sick. Everything is important to him which contributes to that 
object: and, of two things both of which are essential, it can 
scarcely be said that one is more important than the other. If 
it be necessary to understand disease, it is no less necessary to 
be acquainted with the meaDS of cure. This would seem to be 
a self-evident proposition. The question, then, to be decided is 
simply this ; are medicines, which, viewed in the aggregate, and 
in all their different relations, constitute the materia medica, 
necessary to the cure of disease ? I know T that some are, or 
profess to be, skeptical on this point. They have more confi- 
dence in the regulation of the diet and modes of living; in the 
diversified application of temperature, moisture, and air; in 
mental influences ; in depletion by leeches or the lancet ; and in 
other remedial means of a similar nature. Xow, admitting the 
importance of these means, and disregarding the consideration 
that, in its amplest sense, the science of materia medica may be 
said to embrace them, are you prepared to reject medicines, 
strictly so called, as essential in the treatment of disease? Is 
it probable that the experience of forty centuries is utterly de- 
ceptive ; that all the labour, skill, and science, which have been 
expended in collecting, investigating, preparing, and applying 



IMPORTANCE OF MATERIA MEDTCA. 1 1 1 

medicines, have been quite thrown away; that, at the present 
time, almost the whole body of our profession, certainly not be- 
hind the highest in native talent, acquired knowledge, and sound 
judgment, are idly wasting their time in the pursuit of a mere 
ignis fataus? Would it not imply an impertinent self-conceit 
to set up one's own single opinion, without the support of fact 
or reason, against this experience of all past time, this world-full 
of present conviction ? But let us turn to individual instances; 
for single examples sometimes outweigh all general influence in 
their impression on our faith ; and one solitary case, brought 
before the mind's eye, gains for a truth a more ready acceptance 
by the understanding, and a firmer seat in the memory, than a 
thousand arguments addressed only to the reason. 

Enter with me into an infirmary, and examine a few of the 
cases which offer themselves to the spectator. On that bed sits 
a man, who, less than a week ago, came into the ward pale, 
sallow, and emaciated, worn out in health and spirits, with a 
disease which had been hanging about him for weeks, perhaps 
for months, incapacitating him for labour, and rendering his life 
wretched. His complaint was a protracted intermittent. From 
twelve to twenty-four grains of sulphate of quinia cut it short in 
one day; and he is now a well man, eager to enter once more 
upon the duties and enjoyments of life. 

In this other bed lies a patient, recently from |he Southern 
coast of our own country. He is in the second paroxysm of a per- 
nicious intermittent. His pulse is beating with great rapidity; 
his extremities are cold, while he complains of intense heat and 
thirst ; his countenance is sunken, anxious, almost haggard ; the 
hand of death is apparently upon him ; but he has one chance 
of life. The period for the spontaneous subsidence of his parox- 
ysm is at hand ; and the probability is that he will survive it. 
But the third paroxysm, should it seize him, will prove inevitably 
fatal. A leap into the Falls of Niagara would not be more so. 



112 IMPORTANCE OF MATERIA MEDICA. 

What, then, is to save him ? Will the lancet ? Will regimen ? 
Will heat or cold ? Will any form of application into which 
water can be tortured save him ? No, gentlemen, not one, nor 
all together. No earthly power can check his headlong descent 
to the grave, except only one, and that, the power of a medicine. 
Let sulphate of quinia be given to him freely, and it will almost 
certainly rescue him. I can promise you this with the confidence 
of repeated experience. 

Passing onward in our round, we come to a patient universally 
swollen with dropsy. Scarcely a trait of his countenance, or a 
line of his form remains. Unless relieved, he must speedily go 
to his long home. But he has been taken digitalis for several 
days. It has begun to exhibit its effects upon his kidneys. In 
a short time, this bloated mass of disease will have melted away 
before its influence, like snow before the sun. The patient will 
have been saved by a medicine. 

Here is a case of bilious remittent cut short by an emetic ; 
there, another of chronic bronchitis getting well under seneka. 
Proceed, and you will see cases of syphilitic rheumatism, scrofu- 
lous ulcers, and anomalous cachectic eruptions, yielding to 
iodine ; inveterate and most offensive diseases of the skin, to 
arsenic ; and chronic inflammations of all kinds, to mercury. 

I might thus conduct you through every ward in the hospital ; 
not, indeed, with the same uniformly favourable results, but still, 
with illustrations all around us of the palliative or curative power 
of medicines. In our ordinary, every-day practice, how often do 
we see croup yield instantaneously to an emetic ; violent stom- 
achic spasm to an antacid and carminative ; colic and diarrhoea 
to a cathartic ; pain, restlessness, and want of sleep to opium ; 
and spasmodic cough to assafetida ; not to mention any of 
those almost innumerable instances, in which, by skilful combi- 
nation and diversity in the application of medicines, the most 
hazardous and threatening diseases are triumphantly conducted 



IMPORTANCE OF MATERIA MEDICA. 118 

to a favourable issue. I could easily occupy the whole lecture 
with such an enumeration. Believe me, gentlemen, there are 
substances in the catalogue of the materia medica, essential not 
to our comfort only, but also to our safety, and the loss of which 
would be wholly irreparable for humanity. 

You are, I think, prepared to admit the indispensable neces- 
sity of medicines in the treatment of disease, and, consequently, 
the indispensable necessity of understanding them. No man can 
be other than a bungling practitioner of medicine, without an 
acquaintance with the science of materia medica. 

But it may be said that, admitting the importance of certain 
prominent medicines, the number of those really valuable is very 
few ; and that the study of the remainder is merely a waste of 
time. Ignorance and idleness are, for the most part, the parents 
of this very convenient notion. For one unacquainted with 
medicines, and too indolent to acquire a knowledge of them, it 
serves as an easy refuge from the inflictions of his own con- 
science, and the evil opinion of his fellow-men. False hypothesis 
comes happily to his aid, and may even generate an enthusiastic 
devotion to what was originally the mere creature of sloth. 
Sangrados have existed in every age. " Give me opium and 
the brandy-bottle," says one enthusiast ; " give me calomel and 
the lancet," says another ; " and I will fearlessly encounter dis- 
ease." But, gentlemen, disease listens to the vain boast, and 
laughs in his sleeve. He knows well that a wind-mill, or a flock 
of sheep, may suffer in an encounter with such Quixotes in medi- 
cine ; but that he himself has little to fear. 

But men of a higher grade of character, honest searchers after 
truth, have been led into a similar error. The human mind, in 
its vain aspirations after universality of knowledge, struggling 
to embrace the infinite within its finite capacity, seizes eagerly 
upon grand generalities, which may serve to involve a host of 



114 IMPORTANCE OF MATERIA MEDICA. 

individual facts, and thus immeasurably to extend its powers of 
acquisition and retention. This is, no doubt, the correct course, 
if followed with due caution ; with the utmost care to admit no 
general truth, until firmly established by a due series of induc- 
tions from admitted facts. But our impatience is constantly 
overleaping this barrier; and, to avoid the labours of research, 
we have recourse to inspiration. A bright thought flits across 
the fancy of some man of genius. He seizes the unfledged idea, 
cherishes it with solicitous care, and, when sufficiently amplified 
and adorned, with brilliant plumage and expanded wings, ex- 
poses it to the astonished gaze of the multitude, and claims for 
it their homage, as for a messenger from on high. 

Hypotheses of this sort we have had in medicine, and, among 
them, one which had for a time great influence in the spread of 
the very error we are now combating. Vital power is a unit; 
vital action, being nothing more nor less than the exercise of this 
power, is also a unit ; derangement of this action, possible only 
in grade, is another unit; and the measures of relief, being 
merely such as lower the action when elevated, and raise it when 
depressed, must have the same unity of character. A scanty 
materia medica is the necessary pendent to this chain of argu- 
mentation. Born with Brown, adopted and amplified by Rush, 
and appropriated with modifications by Broussais, this hypothe- 
sis, in one shape or another, long exercised a powerful influence 
in the medical world. It was set up, like another golden image, 
by the despotic French reformer, who issued his edict that all 
the world should fall down and worship it, under the penalty, if 
disobedient, of being cast into " the burning fiery furnace" of his 
indignation. And great multitudes did fall down and worship. 
Neither were Shadrachs, Meshachs, and Abed-negos wanting, 
who refused obedience to the decree, and yet escaped unhurt the 
flames of the seven-times heated furnace. But Nebuchadnezzar 
has fallen ; and the image is broken ; and the worshippers are 



IMPORTANCE OF MATERIA MEDICA. 115 

reduced to a few, who, dwelling in the outskirts of the medical 
world, are scarcely yet aware that the great chief is gone, after 
surviving the revolt of almost all his partisans, and the demoli- 
tion of his strongholds. Yet the hypothesis has left behind it, 
in the minds of many who no longer recognize its truth, vestiges 
of its sway, which are observable in their modes of practice, and 
their estimate of our particular branch of medicine. Wanting, 
as they supposed at the outset of their professional voyage of 
life, but few remedial means, and those of the simplest kind, they 
neglected to provide themselves with a knowledge of many 
usually deemed important; and now, when, perhaps, experience 
has thrown some doubt over their previous opinions, they find it 
inconvenient if not impossible to check their onward course, and 
turn their sails backward for a more ample supply. They must 
content themselves with their poverty; while, before the multi- 
tude, they conceal it under the cloak of philosophy. Unable 
fully to avail themselves of the riches clustering about the ma- 
teria medica, they find the grapes sour, and make faces before 
the inexperienced as if their teeth were on edge. 

Now, gentlemen, I would put you on your guard against such 
representations. I would prove to you that not only are medi- 
cines, speaking in general terms, essential, but that it is impor- 
tant to be provided with numbers of them, possessing various 
powers and properties, in order to meet the diversified calls of 
disease. In the first place, I would tell you that experience has 
sufficiently established the fact. The present treasures of our 
materia medica have, for the most part, undergone the careful 
scrutiny of ages. Medicines are often hastily introduced into 
notice upon insufficient grounds, and attain, for a considerable 
time, an undeserved popularity. But at length they are sure to 
find their proper level, and, indeed, not unfrequently sink below 
it. If altogether worthless, they are rejected, and at length for- 
gotten ; or, at best, retain a place in the collections of the curious, 



116 IMPORTANCE OF MATERIA MEDICA. 

as memorials of the past. It may, therefore, be taken for granted, 
that those which hold their position in our officinal catalogues, 
after having passed the ordeal of time, are deserving of that 
position. There may be some, of recent origin, which are 
admitted in reference to their present popularity, and which may 
hereafter be excluded ; there may, moreover, be preparations, 
which will hereafter be superseded by others better calculated to 
answer the same end ; but even these are not exceptions to the 
general value of the catalogue for the learner ; for every physician 
should know something not only of medicines which he values 
himself, but of those also which are valued and used by those 
about him ; and preparations which may some time be improved, 
are essential to us until the period of that improvement shall 
arrive. 

But let us reason a little upon the point. "We know that 
medicines not only differ in their effects upon the system at 
large, but that they also have peculiar tendencies to particular 
parts or organs. A medicine which acts on one organ, may 
produce no effect on another; and there is scarcely an organ in 
our constitution, for which there is not this special affinity on 
the part of some one or more medicinal substances. Need I 
refer you to particular instances? Need I tell you that, while 
quinia, and mercury, and iron, and iodine, all act, to a certain 
extent, upon the whole system, and in modes peculiar to each, 
ipecacuanha will act upon the stomach, castor oil on the bow T els, 
squill upon the kidneys, citrate of potassa upon the skin, can- 
tharides upon the generative organs, opium upon the brain, digi- 
talis upon the heart, and so on through nearly the whole series 
of medicines and of organs ? Now, diseases seated in these 
different parts are sometimes to be reached only by the remedies 
acting on these parts specially; and there is, besides, not an 
organ which may not occasionally be beneficially called into 
action, in order to remove disease seated in another organ, or 



IMPORTANCE OF MATERIA MEDICA. 117 

occupying the whole system. Here, then, is one ground for the 
use of numerous medicines of diversified relations. 

Different medicines, moreover, affect differently the same part 
or system of parts ; some exalting, others depressing, and others, 
again, in some unknown way, modifying its actions. Diseases 
having the same diversity, in the same positions, must conse- 
quently call for these diversified powers in medicines. When 
the heart is excited, it requires to be depressed ; when depressed, 
to be exalted ; when irritated, to be soothed ; when enlarged, to 
be contracted; and there are substances capable, to a certain 
extent, of meeting these several requisitions. The same remark 
may -be extended to all the vital organs ; and thus another 
ground is offered for the multiplication of medicines. 

Remedial substances of the same general mode of action pos- 
sess very different degrees of power, adapting them to various 
grades of severity in disease. To use only the most powerful, 
in all cases, would be like employing a wood-chopper's axe, or 
the scythe of a mower, to shave with ; like shooting a squirrel 
with a twenty-four pounder. It may be said that every desirable 
grade of activity can be obtained by duly proportioning the dose. 
But this is a mistake. The stomach would not hold enough of 
some of the milder medicines to produce the effects of the strong- 
est; and, in relation to some of the more powerful, though you 
may quite annihilate their action by a sufficient reduction of the 
dose, you cannot subdue their violent nature. The hyena and 
tiger may be confined or prostrated by superior power; but you 
cannot tame them. So long as they can act at all, they will act 
according to their savage instincts. Who would think of admin- 
istering croton oil, or elaterium, to accomplish what might be 
readily effected by a Seidlitz powder, or a dose of magnesia ? 
The necessity, then, of having medicines graduated, on the scale 
of activity, to the severity of the disease, or the degree of effect 
required, must lead to a great extension of the catalogue. 



1 IS IMPORTANCE OP MATERIA MEDIC A. 

>':: ie this all. There are peculiarities in the constitution of 
certain individuals, called technically idiosyncrasies, which render 
them wholly rebellious to means that may be admirably adapted 
to ordinary cases. The vulgar proverb, that "what is one man's 
meat is another man's poison us expressive of a sober truth in 
medicine. To meet such idiosyncrasies, it is highly important 
to have different medicines of analogous remedial powers ; so 
that, if one should disagree with a patient, we may have recourse 
: another. 

Again, there are peculiar tastes, likes and dislikes, and even 
prejudices, which it is necessary to consult, if we desire to ac- 
complish the greatest good. Some persons, for example, prefer 
Glauber's to Epsom salt ; others, who dislike both these medi- 
cines, even to nausea, are unaccountably fond of castor oil ; and, 
strange as it may seem, there are not a few individuals who have 
an exceeding relish for those most nauseating drugs, rum and 
tobacco. Now, though I would not so far gratify this peculi- 
arity of tair as to allow of the habitual use of these favourite 
substances in health, yet, in disease, they might constitute a 
valuable resource, when others of analogous powers might happen 
to be offensive. The young practitioner, in his pride of science 
and profession, is apt to be a little despotic, and inclined to force 
medicines on his patients against the stomach of their sense ; 
not to speak of their morbid squeamishness and their prejudices, 
which frequently rise up against his prescriptions. When his 
end can be attained by no other means, it is quite proper that 
he should be thus firm ; but when, by the number of medicines 
at his command, he has it in his power to accomplish the same 
object by means equally efficient, and more acceptable to the 
patient, it becomes his duty, as it undoubtedly is his interest, to 
avail himself of them, and thus avoid the disturbance of system 
which is so apt to result, in the sick, from a contravention of 
their feelings and wishes. The more ample his list of medicines 



IMPORTANCE OF MATERIA MEDICA. 119 

of real efficiency, the better able will he be to meet this demand 
upon his resources. 

Besides medicines in their simple or crude state, there are 
numerous preparations which serve to swell the catalogue for the 
learner. By various modes of chemical or pharmaceutical treat- 
ment, changes are effected in the remedial qualities, strength, 
durability, or convenience for administration of medicines, which 
are in the highest degree important, and cannot be neglected by 
the practitioner with impunity. Substances are thus rendered 
mild or energetic, at the discretion of the operator ; acceptable 
to the palate and stomach, when they might otherwise be offen- 
sive to both ; capable of being preserved without change indefi- 
nitely, instead of undergoing speedy decay ; and, finally, remedial 
in modes altogether unknown to them in their native state. Need 
I mention, as illustrations, quinia from Peruvian bark; morphia 
from opium ; calomel, corrosive sublimate, and the blue mass, 
from mercury; tartar emetic from antimony; and the various 
compounds of iron, and of iodine ? It is sufficient to say that 
the number of medicines is much more than doubled in this way. 

If, then, medicines are essential to the practitioner, and at the 
same time numerous ; and if they require to be understood in 
order to be duly employed ; how can materia medica, which 
teaches their properties and powers, and the modes of applying 
them, be otherwise than an important science ? How can it be 
postponed, with impunity, to the other branches, in a course of 
medical instruction ? 

But you may be told that the knowledge of medicines may be 
easily acquired ; that nothing more is requisite than a moderate 
exercise of the organs of smell, taste, and vision; and that lec- 
tures are scarcely wanted upon so simple a subject, an acquaint- 
ance with which may be taken, almost in the natural way, by a 
short exposure to the odours of an apothecary's shop, or the 
office of a country physician, like the measles or small-pox in 



120 IMPORTANCE OF MATERIA MEDIC A. 

the sick chamber, or the wards of a hospital. This, gentlemen, 
would be the language of imbecility, infatuation, or fraud. Let 
us inquire briefly what it is necessary to know of medicines, and 
then decide whether the knowledge is likely to come easily and 
without aid. 

In the first place, what preliminary knowledge is necessary? 
In answer to this question it may be stated, that, independently 
of the ordinary information which should serve as the basis of 
all professional studies, the learner in materia medica should 
have acquired a considerable proficiency in chemistry, and a 
general acquaintance with anatomy and physiology. The former 
is necessary to enable him to understand the nature and mutual 
relations of medicines, the principles upon which they are pre- 
pared, and, to some extent, their modes of acting in disease. 
Chemistry is, indeed, chiefly useful in our profession as the 
handmaiden of materia medica. Without anatomical and physio- 
logical knowledge, the student could not understand the all-im- 
portant relations of medicines to the system ; for how could he 
appreciate the changes produced by them in the organs and 
functions of the body — changes which constitute almost exclu- 
sively their remedial influence — if ignorant alike of these organs 
and functions ? You perceive, then, that no little expenditure 
of time and labour is necessary in laying even the foundation of 
materia medica. Is it reasonable to suppose that a superstruc- 
ture, requiring so broad a basis, can itself be of trifling magni- 
tude ; that, founded so laboriously, it can be built up without 
rule and without effort ? 

We have seen what preliminary knowledge is necessary. 
Now, let us see what should be known of medicines themselves. 
To begin at the beginning, we should not be ignorant of their 
origin, the places where they are produced, the modes in which 
they are fitted for the market, the routes by which they reach 
us, and the state in which they are obtained from the merchant, 



IMPORTANCE OF MATERIA MEPICA. 121 

before being prepared for the office of the practitioner, or the 
shop of the apothecary. All this knowledge is not absolutely 
necessary to the physician, but it is highly useful in various 
ways. It enables him to appear advantageously, in many in- 
stances, before the world ; to avoid the imputation of ignorance 
in essentials, which might be cast upon him by persons capable 
of appreciating any failure in these minor points ; to escape fre- 
quent impositions in the purchase of drugs, should this enter, as 
it often may do, into his professional avocations ; and, finally, 
to enjoy that internal satisfaction which accompanies the pos- 
session of all kinds of useful knowledge, and especially of that 
which is in harmony with his every-day pursuits. 

Even the names of medicines will be found by the student to 
be some burden upon his industry; and yet, with the knowledge 
of these he cannot possibly dispense. It is not only one name 
for each medicine that he is under the necessity of learning. He 
must know also the most common synonymes ; for how other- 
wise could he understand the works in which they are employed, 
or even the conversation of a medical brother, who might happen 
to use a different name from the one most familiar to himself? 
What would you think of a physician, who should not be aware 
that sulphate of magnesia is only another name for Epsom salt, 
mild or protochloride of mercury for calomel, nitrate of silver 
for lunar caustic, and so on through a long list of medicines ; 
not to speak of the Latin synonymes, which are so much em- 
ployed in published treatises, and so constantly the language of 
prescriptions, that a physician ignorant of them would be liable 
to the most ludicrous, as well as to the most serious blunders ? 

It is scarcely necessary for me to say that the student should 
make himself familiar with the sensible properties of medicines, 
such as their general appearance, colour, taste, smell, and con- 
sistence ; as it is only thus that he can recognize them when 
brought to his notice. The most dangerous mistakes might 



122 IMPORTANCE OF MATERIA MEDICA. 

arise from the want of this knowledge. One of an unpleasant, 
and yet ludicrous character, fell under my own observation. A 
physician was consulted as to the nature of a liquid, of which a 
gentleman had swallowed largely, supposing it at the time to 
be a solution of Epsom salt, though afterwards led, by what cause 
I do not recollect, to entertain some doubts upon the subject. 
After having tasted it, the physician pronounced it to be a solu- 
lution of nitre. Great consternation was, of course, created ; as 
sufficient had been taken to prove fatal, should this opinion be 
correct. The patient experienced an alarming coldness at his 
stomach, with other disagreeable abdominal symptoms, and no 
little disturbance of his nervous system. An emetic, however, 
of ipecacuanha, by evacuating the stomach of the offending cause, 
gave speedy relief; and perfect recovery was quickly established. 
Next day, the messenger who had procured the poison was taken 
to the apothecary's shop where it had been purchased, and, having 
had his attention directed to two parcels of medicine, one con- 
sisting of Epsom salt, and the other of nitre, was told to point 
to the one most nearly resembling that from which so much 
mischief might have resulted. Without hesitation he designated 
the former ; and thus it appeared that an innocent dose of salts 
had been mistaken for a substance of dangerous activity, and a 
gentleman been put into the awkward position of exhibiting 
various imaginary symptoms of poison, with the anxiety and 
perturbation incident to such an occasion, and afterwards learn- 
ing that all this, as well as the nauseous dose of medicine he had 
taken, might have been spared, had the physician possessed a 
more discriminating taste. 

It is not, however, sufficient to be acquainted with the sen- 
sible properties of medicines. Those having reference to their 
chemical relations are not less important. Without a knowledge 
of these, medicines of the most incongruous character might be 
administered together, with the effect of diminishing, increasing, 



IMPORTANCE OF MATERIA MEDICA. 123 

or altering their activity, so as, in either case, to disappoint the 
expectations of the practitioner, and sometimes to lead to the 
most disastrous results. No longer ago than last winter, a young 
member of the class inquired of me, what would be the effect of 
mixing together calomel and nitromuriatic acid. I told him 
probably to form corrosive sublimate. "Then," said he, " I can 
account for the result of a terrible case, in which considerable 
quantities of these two medicines were given simultaneously, 
and the patient died with symptoms of violent gastroenteritis." 
This case is not solitary. Many similar results of incompatible 
prescription are undoubtedly covered over by the cold sod ; not 
even the practitioner himself being aware of the mischief he has 
done. The preparation of medicines for use demands the same 
knowledge of their chemical relations ; the effects upon them, for 
example, of heat, air, and moisture, of the implements employed 
in operations upon them, of the liquid or other vehicles with which 
they may be mingled, of the various circumstances, in fine, which 
attend their administration. Then, some medicines lose their 
efficacy when heated, others when exposed to air and dampness j 
some are injured by contact with metals which are not affected 
by glass or earthenware ; and those which may be safely and 
conveniently prepared with one liquid or powder are often 
wholly incompatible with another. You must readily perceive 
how numerous may be the errors on these various points, and 
how great the inconvenience, not to say mischief, resulting from 
ignorance. 

But there is another set of relations still more important ; 
those, namely, which medicines bear to the system in health and 
disease. Upon these is based their whole therapeutical applica- 
tion ; and, without a knowledge of them, so far as they have 
been investigated and established, no man can have a claim to 
be considered a rational practitioner. It is not sufficient to have 
learned that one medicine is adapted to one disease, another to 



124 IMPORTANCE OF MATERIA MEDICA. 

another, a third to a third, and so on. This sort of knowledge 
would lead to a purely empirical practice, in which the physician 
is only a sort of machine for executing certain prescribed move- 
ments : a hearing and seeing automaton, which, at the name of 
bile, picks up calomel, and at the sight of fever or inflammation 
or hemorrhage, seizes the lancet. Most medicines have modes 
of affecting the system more or less peculiar to themselves ; and 
diseases, as they are presented to our notice, consist usually of 
a combination of various functional or organic derangements. :: 
each of which some one of the medicinal actions may be es- 
pecially adapted. Now, you must be sensible that, in order to 
a rational application of the medicine, both its own proper 
action, and the derangement of system for the cure of which 
this is suited, must be well understood. The former knowledge 
belongs to the department of materia medica, the latter to that 
of pathology. Here, then, is a wide field for the learner, in which 
he must labour much before he can master what is known, and in 
which, after all, there is yet a vast deal to be discovered in the 
progress of time and research. 

Besides all the knowledge in relation to medicines which has 
been already indicated, there yet remains that of the art of pre- 
paring them. This belongs strictly to the pharmaceutist : but no 
physician can be safely altogether ignorant of the principles :: 
the art ; and, as medicine is practised through the greater por- 
tion of our country, not only the principles, but the actual pro- 
cesses and manipulations should be familiar to the practitioner. 
What would be thought of a country physician, who could not 
prepare a tincture, or infusion, or mixture, or pill, who should 
not even understand how to weigh out a dose of medicine, or to 
apportion liquids by proper measures ? and yet all these acts 
require considerable knowledge and skill for their due perform- 
ance. 

You see then, gentlemen, that the science of materia medica 



IMPORTANCE OF MATERIA MEDICA. 125 

is of no trifling importance, of no inconsiderable extent, of no 
easy and unlaboured acquisition. He who tells you differently 
deceives you ; and should you now listen to his seductive voice, 
the time of repentance will assuredly come. When involved in 
the serious responsibilities of your profession, with the sick and 
the dying around you imploring for relief and safety; how will 
you feel, if, in the anxieties, the agitations, the eager and trem- 
bling wishes and fears of the moment, you see the danger, and 
know that means of salvation exist, but cannot tell where to 
find them ; if, standing on the tempestuous shore, and beholding 
the fellow-beings you are bound to protect, tossed about and 
vainly struggling in the terrible flood, you are compelled to look 
idly on, because unprovided with the life-boat which might save 
them ? 

There yet remains one point of our subject to be disposed of. 
Admitting all that I have said to be true, you may ask, and the 
question has been asked, is the aid of a lecturer necessary to 
guide and facilitate your studies ? I will not say that such aid 
is absolutely indispensable. On the contrary, I know that, by a 
clue preparatory course of study, by the industrious perusal of 
works upon materia medica and pharmacy, by a diligent attend- 
ance in the shop of an apothecary, and, after all this, by a course 
of practical experience in the treatment of diseases, sufficient to 
assure you of the relative value of the different precepts you 
may have found in the books, you may at last come out accom- 
plished scholars in this branch of medicine, without the assist- 
ance of those who have trod the same path before you. But, in 
the pursuit, you will have suffered many perplexities, have ap- 
plied much painful labour, and expended much valuable time, 
which might have been spared, had the hand of experience been 
present to guide you. In regular treatises upon this, as upon all 
other sciences, there is much that is of comparatively little value 
to the learner ; much that is introduced merely to complete the 



126 IMPORTANCE OP MATERIA MEDICA. 

system, or to serve as matter of reference when required for any- 
special purpose, whether of curiosity or usefulness. The whole 
is too great a burden for any memory ; and, even if the memory 
were capacious enough to receive and retain it, mischief would 
en&ue from the necessary exclusion of more important facts, be- 
longing to other departments of knowledge ; for all human capa- 
city is finite. But how is the learner to know which are the 
important points unless informed ? How will he be able to select 
the wheat and leave the chaff, unless he can distinguish between 
them ? We have no winnowing machines which will perform 
this duty for him. He must either devour the whole, with the 
danger of nausea and repletion, or must select a part, with the 
risk of choosing the least valuable, and neglecting what is most 
important. A lecturer will perform this office of selection for 
him much better and more effectually than he could perform it 
for himself. The remark, it is true, applies to the mode of in- 
struction in most of the sciences ; but it is especially applicable 
to ours ; for in scarcely any are the isolated facts, out of which 
a selection must be made, so exceedingly numerous. 

Another advantage of lectures is to serve as a sort of arbitra- 
tion between conflicting statements or opinions, which equally 
press upon the notice of the learner, and claim the right to be 
adopted. One author says one thing, another says another, and 
the two are often conflicting. How is the student to make a 
choice between the two bundles of hay, each one of which seems 
equally attractive ? His best plan is to put himself under the 
direction of a more experienced individual, in whom circum- 
stances may have induced him to place confidence ; and to follow 
his lead, until sufficiently advanced to be able to form a judicious 
opinion for himself. He may sometimes, possibly, be led into 
error ; but this he can afterwards correct, when his opportunities 
extend, and his judgment becomes matured ; and, at any rate, it 
is better to be mistaken in some points, than to be constantly 



IMPORTANCE OF MATERIA MEDIC A. 127 

floundering about in uncertainty, with anxious but vain efforts to 
attain some fixed ground upon which to stand. 

Another strong reason for lectures on materia medica, is that 
it is strictly a demonstrative branch of knowledge. At least, as 
such I have always taught, and still continue to teach it. There 
is scarcely one of its departments, excepting that of therapeuti- 
cal application, which does not admit of practical illustration in 
a course of lectures. It may, in this respect, almost take a 

position by the side of anatomy and chemistry, which, you are 

i 
aware, are pre-eminently the demonstrative branches of medical 

science. 

I appeal to you now, gentlemen, if I have not established the 
propositions, in relation to our science, which were the starting- 
points of this lecture. Are you not convinced, not only that 
materia medica is important, extensive, and worthy of your best 
efforts to master it ; but that lectures upon the subject may be 
of great, almost indispensable value to the learner? But I do 
not wish you to be alarmed. There are no difficulties about it 
which are insuperable, none which diligence may not overcome 
if properly guided and supported. I am entirely sure that I can 
make it much easier for you than you would find it without aid. 
Nor do I expect impossibilities from the student. I know his 
limited time; in many instances, his limited opportunities; and 
can make the requisite allowances. All that I ask from him is 
an earnest effort to master the subject, and a disposition to make 
the most of the opportunities offered him. I promise you my 
best aid ; and I do so, not merely in the cold formality of official 
duty, but with the most friendly dispositions, with the anxious 
desire to facilitate your labours, and to witness your success. 



LECTURE IV. 



DELIVERED NOVEMBER 6th, 1837. 



Abuses to which the Materia Medica is liable in Practice. 

Gentlemen : — 

I should be doing injustice to my feelings, were I to enter at 
once upon the business for which we are met together, without 
a kindly greeting to the many old friends whom I recognize 
among you, and a hearty welcome to those yet unknown to me, 
whom I hope to see no less my friends before we part. 

You are about to enter on a toilsome pursuit, and have applied 
to our greater experience for aid and counsel. These it is our 
duty to afford you ; and it becomes us to consider in what way 
they may be imparted most effectually for your good. It is not 
sufficient to lay before you the bare materials of knowledge, to 
be connected and fashioned as your own taste and judgment may 
dictate. Nature, whether moral or physical, seldom presents 
her elements in an isolated state. She variously combines them, 
arranges the results of her grand chemistry in numberless 
shapes of use or ornament, invests each individual existence 
with infinitely diversified relations, and, by an invisible cord of 
union, binds all her vast materials, however apparently discord- 
ant, in one great and harmonious whole. Science is nothing 
more than the interpretation of nature. Each department of 
knowledge, or of art, is but one of the sections of her boundless 
(128) 



ABUSES OP THE MATERIA MEDICA. 129 

dominion. Instruction, to be perfect, must be a copy of her 
works. The branches of study which are to engage your atten- 
tion are all shoots of the same great trunk, and obedient to the 
same laws. In our endeavours, therefore, to teach you, we 
should aim always at an approach to nature. We should pre- 
sent you with the elements of knowledge ; but we should also 
make you familiar, so far as our own short-sightedness can 
penetrate, with all their combinations and relations having any 
bearing upon your pursuit. Such is the principle which will 
guide me in teaching materia medica. My intention is not only 
to introduce to your notice individual medicines ; but also to 
treat of them in all their bearings ; to give you at least a sketch 
of all those various courses of action and opinion in which they 
constitute essential objects. With these intentions, I cannot 
pass over unnoticed the abuses to which medicines are liable. 

It is the tendency of addiction to any one pursuit, to magnify 
its advantages, .and, in an equal degree, to underrate its attend- 
ant evils. There is little danger that a teacher of materia med- 
ica will fail sufficiently to impress upon the student the import- 
ance of medicines ; there may be some, that he will turn to his 
audience exclusively the bright side which he loves to contem- 
plate himself, and neglect to put them upon their guard against 
the perils to which they are exposed. I shall endeavour to avoid 
this error ; and, though unwilling to damp your ardour by in- 
stilling unnecessary or fanciful apprehensions, shall not shrink 
from the duty of pointing out dangers, whenever I may myself 
be aware of their existence. Much that has relation to the mis- 
use and abuse of medicines may be most advantageouly reserved 
for the occasion when each medicine is to be individually con- 
sidered ; but I do not know that I can do better than avail my- 
self of the present opportunity, to offer some views of a general 
nature, which may possibly be found useful, at the same time, 
in guarding you against errors yourselves, and in enabling you 

9 



130 ABUSES OF THE MATERIA MEDICA. 

to counteract, in some measure, the mischief resulting from the 
errors of others. In order to render the subject clearer and 
more impressive, I shall endeavour to arrange, in a regular 
series, the various sources of error in the employment of medi- 
cines, so far as I have been able to discover them, giving pre- 
cedence to the least copious, and reserving for the close such as 
send forth their flood of evil most abundantly. 

Physicians, even though well instructed, particularly those 
young in the profession, are apt to attach undue importance to 
the influence of medicines, not sufficiently considering the char- 
acter of the pathological condition, nor how impossible it often 
is to effect salutary changes in this condition by other means 
than the slow operations of nature. Administering a remedy 
in some complaint in which it may appear to be indicated, and 
not finding a degree of amendment equal to their impatience, 
they are tempted either to increase the dose too rapidly, and 
thereby incur the risk of seriously complicating the disease, or 
to resort prematurely to other really less eligible means. They 
are, moreover, under the constant inducement to prescribe medi- 
cines, where patience and the careful avoidance of perturbating 
agencies are all that is necessary to the cure ; and there can be 
no doubt, that the thread of life has often been snapped by the 
officious hand of the physician, rashly thrust into the deranged 
vital process, which required only time for a favourable issue. 
I believe, however, that this source of evil is daily diminishing, 
under the brighter light which multiplied observation is pouring 
upon the field of pathological medicine. The age of heroic doses, 
like that of heroic deeds, is retreating before the march of sound 
reason and common sense. It is chiefly in the outskirts of the 
profession that the attempt is now made to take disease by 
storm. The number is comparatively few, who would choose 
to beat down defences by a shattering caunonade of calomel, 
which are ready to surrender on demand, or to yield uninjured 



ABUSES OF THE MATERIA MEDICA. 131 

to a gentle siege of starvation. Against the risk of a too fre- 
quent or too abundant recourse to medicines, there is no better 
safeguard than a diligent study of pathology in its present im- 
proved and improving condition ; and this study, therefore, I 
urge upon you, with the caution, however, that you guard 
against its seductions, and remember that, though it is highly 
desirable to understand the nature of disease, it is still more so 
to be able to cure it. 

A disposition to employ medicines too profusely may some- 
times have its origin in another source. Over a large portion of 
our country, the physician supplies his patients with medicine 
as well as advice, and receives compensation for both. It thus 
becomes his interest, in a pecuniary point of view, to leave no 
opportunity for the insertion of a dose unimproved ; and, though 
the great majority of practitioners are of a grade of morals above 
such an influence, it is yet not altogether unfelt, and probably, in 
many instances, operates insensibly in giving a bias to the judg- 
ment. In England, where much of the medical practice is in the 
hands of the apothecaries, who until recently were allowed to 
charge only for medicines, and could demand no compensation 
for advice, the influence of this principle of self-interest over the 
consumption of drugs has been enormous. Imagine a case of 
disease, such as frequently occurs, requiring only a watchful 
guard against injurious influences ; represent to yourselves the 
practitioner making his daily visit, and each time retiring with 
the consciousness that his services must remain unrequited, 
unless he can find occasion for the employment of medicine ; is 
it in human nature to resist the tendency of such a position? 
Even where conscience is firm, will not the judgment almost 
inevitably yield to the constant solicitation of interest ? Will not 
the almost certain result be the discovery of latent indications 
for some pill or potion, which, by going down the throat of the 
patient, may allow a fee to enter the pocket of his attendant ? 



132 ABUSES OF THE MATERIA MEDIC A. 

I have understood that it was formerly no uncommon practice 
with the apothecary in England, when occasion was supposed 
to exist for some mild medicine, such, for example, as a dose of 
salts, to send it in half a dozen potions, to be taken at intervals, 
at the cost to the patient of one or two shillings for each dose. 
The system which led to such abuses was in the highest degree 
absurd, and has been so far modified as to allow the apothecary 
to make a charge for his advice ; but the customs of prescribing 
to which it gave rise are still in existence ; and the English con- 
tinue to deserve the credit, which they have long enjoyed beyond 
all other nations of Europe, of being a drug-consuming people. 
In consequence of this tendency to abuse, as well as for other 
very important reasons, it is highly desirable that the prescribing 
and dispensing of medicines should be in different hands. In 
Philadelphia and some other of our larger towns, the separation 
has already been effected ; and a movement towards the same 
result is observable in most parts of our country, where the 
population is so distributed as to admit of it. I would strongly 
press on you the propriety of contributing your own efforts in 
forwarding this movement, when you shall have entered that 
practical career, to which most of you are now looking forward. 
If the physician, in early life, is in danger of overvaluing 
medicines, and consequently of prescribing them too profusely, 
he is no less in danger, as he grows older in practice, of restrict- 
ing the number employed within too narrow limits. Disease 
often runs for a long time in particular channels, and requires 
particular courses of treatment. Medicines not calculated to 
answer the indications most frequently presented, are apt to 
escape the recollection of the practitioner, or leave but faint and 
ineffectual traces in his memory. He finds it irksome to main- 
tain, by constant study, a knowledge which is but of occasional 
application. The heavy armour with which he was loaded in 
the outset becomes fatiguing in the progress of his march, and, 



ABUSES OP THE MATERIA MEDICA. 133 

finding portions of it of no use upon ordinary occasions, he indo- 
lently throws them away, and thus leaves himself destitute of 
the requisite means of offence against disease, presenting itself 
in new and unexpected forms. He acquires a routine habit of 
prescribing certain medicines, which thus assume an undue 
prominence in his estimation, and present themselves on every 
occasion of emergency, to the exclusion of others better adapted 
to the novel circumstances. A similar result frequently grows 
out of an indolent mental habit, which shuns on every occasion 
all labour of thought that is not absolutely essential. To con- 
sult, in the choice of medicines, the caprices of the palate or 
stomach, the prejudices of opinion, and the various contrarieties 
of a nervous or irritable temperament, though not unfrequently 
of great importance to the successful treatment of disease, 
requires an effort of memory and judgment which is too often 
avoided by practitioners, not conscientiously alive to all the 
duties of their station. Numerous remedial substances, which 
may be considered as light troops to be employed in our skir- 
mishes with disease, or as a reserve against sudden emergencies 
and peculiar danger, are thus entirely neglected, and become 
useless in the conflict. You will agree with me in the opinion, 
that he who wishes to qualify himself best for the practical duties 
of our profession, should sedulously guard against these sources 
of error. For this purpose, he should not only as a student 
form an intimate acquaintance with the materia medica, but 
afterwards, on entering into practice, should resolutely determine 
to maintain and improve this acquaintance by a frequent refer- 
ence to works upon the subject, even when no immediate call 
may exist for the practical application of the knowledge thus 
acquired. 

The influence of fashion and that of novelty are often felt in 
the use of medicines. A new remedy, or some new modification 
or application, or the simple revival of one before known, comes 



134 ABUSES OF THE MATERIA MEBICA. 

accidentally to the notice, or suggests itself to the researches of 
an ardent practitioner, who is willing to believe what he hopes, 
and, in his experimental investigations, can see nothing but con- 
firmation of his belief. The world soon receives the benefit of 
his observations, which a sense of duty may have brought forth, 
but which lose none of their attractiveness in passing through 
the nursing hands of self-interest and love of distinction. The 
journals glow with the rapture of a new discovery. Excitable 
imaginations catch the sparks which scintillate from their pages, 
and kindle into enthusiasm. The flame spreads rapidly, till at 
length even sluggish natures are warmed into action ; and the 
whole profession turns from its accustomed course to luxuriate 
in the new hopes which are opened before it. The medicine 
thus brought into vogue receives the stamp of fashion, which 
continues to give it general currency, till some other novelty is 
struck off, and by its bright freshness puts to shame the tarnished 
and worn-out attractions of its predecessor. Thus, in the prac- 
tice of our profession, as in everything else connected with the 
feelings and thoughts of men, one wave incessantly follows 
another ; and the general welfare, instead of advancing smoothly 
upon an unruffled tide, is tossed about and retarded, and some- 
times almost wrecked in the surges of unstable opinion. It 
becomes every practitioner to contribute all in his power towards 
a more equal and consistent progress. He should strengthen 
himself, by the influence of judgment and discretion, against the 
paroxysms of excitement to which we are all more or less ex- 
posed. Without absolutely rejecting every novelty which may 
float along the current of events, he should be careful not to 
endanger his balance by reaching out too far to seize it, and 
should never allow himself to be carried away by the flood of 
fashion from any well-established and advantageous position. 
In this spirit, he should coolly examine the claims of alleged 
discoveries, trusting nothing to partial testimony, which in medi- 



ABUSES OF THE MATERIA MEDICA. 135 

cine is excessively deceptive, and, having sifted out the truth by 
careful trial, should give it an appropriate place in his store- 
house of practical knowledge, without allowing it to disturb 
unnecessarily the general arrangement, or to displace any im- 
portant fact or principle. 

More injurious than either of the preceding sources of mischief, 
is the influence of false theory upon the employment of medi- 
cines. Almost from her birth, materia medica has been the 
sport of hypothesis. Tossed about from one medical creed to 
another, and sometimes almost torn asunder by the struggles of 
opposing parties, she has survived to the present time, to be still 
exposed to bufferings on the one hand, and injudicious fondling 
on the other, from which all the efforts of sound judgment and 
common sense are requisite to save her unhurt. You may receive 
it as an indisputable truth, that any claim to your guidance in 
the use of medicines, founded upon an hypothesis assuming to 
be of universal or even general application, is wholly groundless 
and futile. The facts of our science are yet far too limited to 
enable us to form a general theory of medicine upon the only 
true foundation, that of strict induction. How is it possible for 
us to draw from our knowledge of the human system a doctrine 
explanatory of all its morbid actions, when we are almost wholly 
in the dark as to the nervous functions, and of the principle of 
life itself know scarcely more than its existence ? We might as 
well attempt to form an accurate map of a country from our 
knowledge of a few of its prominent points, while ignorant alike 
of its boundaries and its interior. Yet so presumptuous is man, 
that he frequently undertakes the impossible task. With intel- 
lectual powers, which, in comparison with the object, are infi- 
nitely feeble, he strives to penetrate the secret counsels of 
Almighty wisdom. Like the giants of old, he heaps up his 
mountain upon mountain, and with audacious vanity hopes to 
seize upon heaven itself by violence. There is only one path to 



136 ABUSES OF THE MATERIA MEDICA. 

truth in science, and that is the straight but narrow and laborious 
path of observation and experience. It is true that false theories, 
if without practical bearing, may sometimes be useful as aids to 
the memory; but, when they have relation to human life and 
happiness, they become engines of incalculable mischief. Sys- 
tems of medicine, therefore, claiming to be universal in their 
scope, as they are necessarily false, must be of the most injurious 
practical influence, and, though often attractive to the inexperi- 
enced by their apparent beauty and labour-saving promises, 
should be discarded as sweetened poisons poured into the very 
fountain of life. It is a most grateful reflection, that the present 
tendency of the enlightened part of the profession is in an oppo- 
site direction. Medical men have at length begun to enter the 
Baconian path. It is now becoming the fashion to observe accu- 
rately and extensively, to collect facts abundantly, to sift these 
facts by a most rigid scrutiny, to compare them with the greatest 
care, and to draw no inference which is not so hedged round by 
various defences as to be almost unassailable. Though this 
system has had numerous advocates, no one has done more 
towards rendering it popular, and bringing it into extensive 
practical operation, than M. Louis, of Paris, whose works are 
models of scientific exploration applied to medicine, and whose 
pupils, both in France and this country, inspired by a zeal little 
inferior to his own, are labouring successfully in the same great 
cause. At present, therefore, we have, as a profession, less to 
fear from false theory than at any former period. 

It is true that the homceopathists, or disciples of Hahnemann, 
are said to be making considerable impression on the community, 
and some practitioners of that school are supposed to be reaping 
largely the fruits of public credulity ; but the profession itself has 
not become contaminated, and none but a few of peculiarly ex- 
citable imaginations are ever likely to yield up their judgments 
to its monstrous absurdities. I feel that it is wholly unnecessary 



ABUSES OP THE MATERIA MEDICA. 137 

for me to guard you against a doctrine which prescribes, for the 
cure of each particular disease, the medicine most closely imita- 
tive of the disease in its effects upon the system, and recognizes 
the greatest curative efficiency in doses, no matter of what medi- 
cine, varying from the millionth to the decillionth of a grain. 
Luckily for the dupes of this imposture, the enormity of the first 
branch of the hypothesis is neutralized by the almost incon- 
ceivable folly of the second. Thus, upon the homoeopathic doc- 
trine, you ought to cure apoplexy by a blow upon the head ; but 
the blow must be of no greater force than the millionth part of 
the weight of a feather : in other words, you do not kill your 
patient because the means you employ are wholly inert. The 
fact is, that homoeopathy is nothing more than a childish halluci- 
nation, which shakes its little fist at the giant of disease, and at- 
tributes the overthrow occasioned by the mighty hand of nature 
to its own Lilliputian blows. But, though it does little positive 
harm, it is the indirect cause of much evil by preventing positive 
good. It is desirable, therefore, that the community should be 
protected against its impositions ; and it becomes the duty of 
the physician, to do what lies in his power to disabuse those 
who may have been captivated by its pretensions. 

The only hold of homoeopathy upon public favour is its appa- 
rent success. You may uncover its absurdities to the under- 
standing, and most persons of good sense will join with you in 
condemning it; but others will answer that they do not pretend 
to be capable of estimating medical theories, that they judge by 
the result, and that, in relation to the system in question, this is 
often favourable. Patients treated by the homceopathists get 
well ; and sometimes they are asserted to have got well after 
the usual medical treatment had been fruitlessly exhausted. 
This is the stronghold of all irregular practice ; and, unless you 
can conquer it, argument and ridicule will equally fail to produce 
an impression on the minds of many, whose imagination and 



138 ABUSES OF THE MATERIA MEDICA. 

capacity of belief are stronger than their judgment. Indeed, the 
minds of some persons are so constituted as to find attractions in 
moral extravagance and absurdity; and, if they have the least 
apparent basis of fact to stand upon, will exhibit a faith equal to 
any possible emergency. In the absence, however, of even this 
slight footing, nothing short of insanity could withstand the 
assault of reason and ridicule combined ; and homoeopathy must 
fall into immediate disgrace, if its claims to great practical suc- 
cess can be upset. 

It would be folly to deny that patients recover in the hands of 
the homoeopathists ; and I believe that a much larger proportion 
recover than under the treatment of irregular practitioners in 
general. Nay, I will go further and admit, that a disciple of 
Hahnemann may be more successful than a very ignorant and 
unskilful physician, even though the latter may take rank in the 
regular corps. But what is the real cause of this apparent suc- 
cess ? I have too good an opinion of your common sense to 
suppose, that you can for a moment be disposed to ascribe it to 
the infinitesimal doses administered to the patient. Can any 
one of you possibly believe, that the decillionth of a grain of any 
medicine kept in the shops, a portion far too minute to be visible 
to the naked eye, and which the most powerfully magnifying 
microscope would be insufficient to detect, is capable of producing 
the slightest impression on the system ? The truth is, that the 
suecess of the homoeopathists is almost exclusively negative. If 
their doses are too feeble to do good, they are equally incapable 
of doing harm ; and the patient gets well in the natural progress 
of the complaint. The tendencies of the great majority of dis- 
eases are towards health ; and, if no disturbing cause be allowed 
to interfere, they will sooner or later terminate in recovery. 
This fact cannot be too strongly impressed upon medical men, 
or upon the community at large. It is a common notion, that 
every complaint which ends favourably is cured by the means 



ABUSES OF THE MATERIA MEDICA. 139 

employed in its treatment. Physicians themselves often act as 
if they were under this impression, and, even when they know 
better, do not always take due pains to enlighten their patients 
on the subject. They are willing to reap the advantages of the 
credit ascribed to them, without duly considering that, by their 
acquiescence, they are playing into the hands of irregular prac- 
titioners. If every case which gets well under the care of a 
physician is a cure, so is every case which terminates similarly 
in the management of a honiceopathist or a Thompsonian. Thus 
must the public reason ; and, as great efforts are made by every 
irregular aspirant to their favour to parade these cures before 
them, it is not at all surprising that they are frequently deceived, 
and yield their support where it is not deserved. Let people be 
taught the simple truth in relation to the natural progress of 
most diseases; let the physician always be satisfied with the 
amount of credit really due to him, and take care that nature is 
not defrauded of hers ; and it is scarcely doubtful that the com- 
mon sense of the community will be able to estimate irregular 
pretensions at their real value. They, like ourselves, will see 
in the supposed cures of the homceopathist the real triumphs of 
nature, and in those of the more venturesome empiric, either 
the lucky blunders of ignorance, or the successful struggles of a 
good constitution alike against the disease and the medicine. 
Nor need we apprehend that they will not duly appreciate our 
own services. Though nature may cure most attacks of dis- 
ease, yet there are many which are beyond her unassisted powers ; 
and there are still more in which her efforts may be materially 
aided, and the amount of suffering to the patient vastly dimin- 
ished by judicious medical interference. Let us rid ourselves of 
all false pretensions ; let it be seen that we stand on the firm 
foundation of common sense, that our time and efforts have been 
directed to the search of truth, and that, having no interest dis- 
tinct from that of the community, we can have no object in 



140 ABUSES OF THE MATERIA MEDICA. 

deceiving them ; and there can be no doubt that we shall be 
consulted in disease, whenever there is pain to be relieved, or 
supposed danger to be averted. 

But the apparent success of the homceopathists is not ascriba- 
ble, in all cases, to the natural progress of disease towards health. 
Much may also be attributed to the influence of new and strange 
processes upon the mind of the patient. In all purely nervous 
complaints, and in many others of a more complicated nature, 
the production of some profound impression on the feelings or 
imagination will often occasion a temporary, if not a perfect 
cure. There is no difficulty in understanding this fact. The 
brain, which is the centre of all sensation, is also the seat of the 
intellect and passions. When the latter are excited into power- 
ful action, the brain is necessarily affected ; and we can easily 
conceive that it may be rendered incapable, by the new condition 
in which it is placed, of perceiving those derangements which 
before occasioned pain, or gave rise to some irregular action. 
They who have suffered with toothache well know how often 
the pain entirely vanishes, under the immediate expectation of 
the interference of the dentist. When the complaint is a mere 
functional derangement, a permanent cure may often be effected 
by a repetition of impressions, producing a continued revulsion 
to the brain. Now, with the homceopathists, as with others of 
the same group of practitioners, it is customary to employ meas- 
ures calculated to make a strong impression on patients of an 
excitable temperament. Their close examination into the con- 
dition of every function and every organ ; their numerous in- 
quiries as to the past history, sentiments, passions, and habits 
of the patient ; the commission, in many instances, of all the 
information thus derived to paper, in order that it may be scru- 
pulously examined ; and then the solemn earnestness with which 
they advise the very careful smelling of an empty bottle, or pre- 
scribe one of their almost preternaturally small doses ; all this 



ABUSES OF THE MATERIA MEDICA. 141 

excites and occupies the attention, calls the passions and imagi- 
nation into play, and involves the mind in a kind of wondering 
awe, admirably calculated to revolutionize the condition of the 
nervous system. That real cures are sometimes thus effected, 
and temporary alleviations still more frequently, cannot be 
doubted ; but means of a similar tendency have produced the 
same results in all times and countries j and homoeopathy, in 
this respect, may rank with the touch of a dead man's hand, the 
pow-wowing of the Indian doctor, and the more refined charla- 
tanry of animal magnetism. 

Still another cause of the occasional triumphs of the homceo- 
pathist is the remaining influence of previous regular treatment. 
The remedies employed before the commencement of his attend- 
ance sometimes continue their favourable operation, or begin to 
operate, after the patient has fallen into his hands; and the 
credit thus accrues to him which belongs properly to another. 
An instance has been related to me, in which a patient with 
amenorrhoea, who bad been for some time under regular treat- 
ment, without apparent advantage, resorted to the advice of a 
homceopathist, and in less than twenty-four hours was gratified 
by a restoration of the suspended function ; but the credit which 
the new attendant might have derived from this accident was 
prevented by an unfortunate declaration which he had made, on 
his first visit, that no good could be expected until the remedies 
of his predecessor should have been removed from the system, 
and that for two weeks at least his efforts would be directed to 
that end exclusively. 

Upon all these points it is important that the public should 
be enlightened. Let them understand the true ground of those 
successes which are so diligently paraded before them, and their 
minds, extricated from the web of false inference in which they 
had been entangled, will judge correctly of the relative value of 
pretensions to their approval and support. They will recognize, 



142 ABUSES OP THE MATERIA MEDICA. 

in the elaborate preliminary examination of the homoeopathic 
physician, the mountain in labour, and in his infinitesimal doses, 
the ridiculous mouse. The whole system, which, viewed 
through the distorting medium of false assertion, seemed to be a 
real though mysterious and wonderful fabric, will to their un- 
perverted vision appear what it actually is, the phantasm of an 
excited imagination, a mere intellectual illusion, better adapted 
to the sphere of a lunatic asylum than to the purposes of common 
life. 

The last and most prolific source of the abuse of medicines is 
the ignorance of those who undertake to employ them. Even 
within the limits of what is usually considered the regular pro- 
fession, there is unfortunately much presumptuous incompetence. 
The best informed physicians often have occasion to regret the 
inadequacy of their knowledge ; how woful, then, must be the 
blunders of those who enter into the practice of medicine almost 
without preparation, who have merely gone through the initia- 
tory forms requisite for admission into our ranks, with as little 
previous expenditure as possible of time and study ! The num- 
ber, however, of badly instructed, of wholly uninstructed physi- 
cians, in this country, is an evil incident to its comparative 
youth, and is daily diminishing with its increasing age. The 
establishment of medical schools, at various remote points, has 
tended to elevate the standard of attainment, by bringing in- 
struction within the reach of many who would otherwise have 
been content without it. The leaven of improvement has en- 
tered the profession, and will not cease to work till the whole 
mass is leavened. The time, I have little doubt, will come, when 
no one will undertake the practice of medicine without having 
availed himself of the advantages of the schools ; and a degree 
will be as necessary a prerequisite in all parts of the country as 
it now is in our larger cities. The question will then be in medi- 
cine, as it must be in evervthin connected with humanity, not 



ABUSES OF THE MATERIA MEDIC A. 143 

between skill and utter incompetency, but between different de- 
grees of knowledge ; and the lowest grade will still be far above 
that of absolute ignorance. 

But it is in quackery that the source of abuse of which we 
are now speaking exhibits its most deleterious influence. This 
is an evil to which, in some of its various forms, every nation, 
however well guarded by laws, is in a greater or less degree ex- 
posed ; but in a country like ours, where liberty is almost riot- 
ous, and individual will is constantly pressing upon the public 
good, it is scarcely possible to fix restraints upon a practice, 
which appeals so strongly to the hopes and fears of the ignorant 
multitude. As in our spiritual affairs, each claims the right of 
walking in his own path, his own interest only being concerned; 
so, in the care of our bodily health, we are unwilling to relin- 
quish a similar privilege, even though, in the opinion of those 
best informed, our course may lead to destruction. Hence em- 
piricism broods almost undisturbed, and her venomous offspring 
swarms in every corner of the land. It is not my intention to 
describe the various forms of her evil progeny. Even were the 
object worthy of the labour, time is not allowed me to enter into 
the disgusting detail ; and I am entirely confident that not one 
of my auditors needs any warning, to keep his own skirts clear 
from the contamination. The relation which every high princi- 
pled medical man must bear to quackery is that of uncompro- 
mising hostility ; and the considerations in regard to it which 
have the most interest for him are such as concern the defence 
of the public against its seductions. A few general observations 
on this point, which, if time permitted, might be greatly extended, 
will close the present lecture. 

One of the most efficient means of successfully combating em- 
piricism, is to elevate the standard of attainment in the medical 
profession. Where this is low, it is not easy for the public to 
distinguish between the pretensions of the regular, and those of 



144 ABUSES OF THE MATERIA MEDICA. 

the irregular practitioner. Quackery triumphs when she sees 
herself reflected in the practice of physicians. Let the student 
leave no opportunity unimproved of qualifying himself for the 
discharge of his future duties ; let the practitioner, so far from 
being content with the attainments of his youth, cherish studious 
habits, and aim at constantly increasing knowledge and skill ; 
let all who have at heart the honour of the profession, encourage 
those only to enter it who are suitably gifted with talent and 
industry, and urge upon these the importance of ample prepara- 
tion ; and we shall soon establish so strong a line of distinction 
between regular practice and empiricism, that the dullest eye 
will scarcely fail to recognize it, and the dullest intellect to per- 
ceive on which side of it will be the greatest security. 

But, above all other things, it is important that the physician 
should not in any way countenance quackery, or encourage it 
even in its least pretending forms. If, from facility of disposi- 
tion, distrust of our own qualifications, interested views, or 
from any other cause, we afford the slightest opening for the 
insertion of its roots, it is sure to fix its parasitic growth upon 
us, and to flourish at our expense. Touch not, taste not, handle 
not — should be our motto in relation to this great evil. Is a 
secret remedy offered for our trial or approval — we should firmly 
decline the insulting offer, and let it be clearly understood that 
we recognize no secrets in medicine. Does a patient ask our 
permission for the use of some nostrum whose character is un- 
known to us — we should resolutely resist the solicitation, and 
yield up the case altogether rather than retreat from our posi- 
tion. It is not the mischief which might result, in any particu- 
lar instance, that should influence us, so much as the danger of 
sanctioning a deleterious principle. Should we incautiously 
recognize the efficacy of some empirical remedy in a single case, 
our stamp will be immediately placed upon it : and, in spite of 
subsequent remonstrances, it will be made to pass current for 



ABUSES OF THE MATERIA MEDTCA. 145 

whatever value its unprincipled circulator may find his interest 
in attaching to it. Should one of these nostrums be employed 
under our observation, and the patient recover in spite of it, the 
cure will be ascribed to the medicine, and serve as the founda- 
tion of its less innocent use in other cases of supposed analogous 
character. There is no end to the mischief which may thus 
grow out of an inconsiderate act, on the part of an influential 
physician. But, if prohibited from giving our sanction, in the 
remotest degree, to the empiricism of others, how careful should 
we be to keep our own hands clean ! To put forth a secret 
remedy ourselves, or to permit our name to be attached to such 
a remedy, is to afford the strongest possible support of example 
to the cause of quackery. There are other practices which, 
though not strictly empirical in themselves; have acquired a 
suspicious character from association, and should therefore be 
carefully eschewed by the physician. To bring our successes or 
supposed successes in every possible way before the public, to 
support our own doubtful statements by the auxiliary certificates 
of volunteer or recruited witnesses, to proclaim our superiority 
over our fellow-practitioners in some branch of the healing art, 
to which we wish to have it believed that we have devoted par- 
ticular attention ; these and other analogous modes of proceed- 
ing are so often put in practice by notorious quacks, that the 
physician who resorts to them cannot escape the imputation of 
countenancing these impostors, and must be content, while he 
aids their cause with the public, to take rank with them in the 
thoughts of his professional brethren. 

It is not by openly attacking empiricism before the public, that 
we can hope to overthrow it. Our arguments make little impres- 
sion, as they are supposed to proceed from interest ; and the 
sympathies of the multitude are drawn to the party assaulted, 
by the cry of persecution. The privilege of reply is, moreover, 
made available for the purpose of puffing ; the attention of the 

10 



146 ABUSES OF THE MATERIA MEDIC A. 

public is roused by the controversy; and great numbers become 
familiar with the wonders of the panacea, who might otherwise 
have never heard of its existence. Besides, in disputes of this 
kind, the party which has most self-respect is usually in the most 
disadvantageous position ; as he feels under restraints in relation 
to the truth of assertion, and the proprieties of language, which . 
are scorned by his opponents. The profession scarcely commits 
a greater error in originally yielding countenance to empirical 
pretensions, than in subsequently assaulting these pretensions 
through the public press. The flame which might have expired 
without the first favouring breath, is increased into a conflagra- 
tion by the blast intended to extinguish it. All that we can do 
with advantage is to bring occasionally before the public the 
adverse incidents in which empirical practice is exceedingly 
fruitful, and, placing them in their true light, without attempt at 
false colouring or exaggeration, to leave them to their legitimate 
operation upon the common sense of the community. 

But the same caution is not necessary in our private communi- 
cations. Every physician has a certain circle within which he 
moves, and in which his professional opinions, duly expressed, 
cannot but have considerable weight. As circles of this kind 
make up, in the aggregate, almost the whole community, it fol- 
lows that medical men, acting in unison, must have it in then- 
power to produce a strong impression upon public sentiment in 
relation to all the concerns of health. Let us reason in the fol- 
lowing manner with our friends and patients. You will admit 
that in any common art, they only are to be trusted who have 
made this art the object of especial culture. You would not go 
to a painter for instruction in music, nor to a musician for your 
portrait. In what does the art of medicine, in this respect, differ 
from others? Who are most to be trusted, they who have 
endeavoured to make themselves acquainted by laborious study 
with all that has been learned in relation to disease and its treat- 



ABUSES OF THE MATERIA MEDICA. 147 

ment, or they whose only title to notice consists in their own 
assertions ? Is not some knowledge of the human system, in 
its healthy state, requisite for those who attempt to remedy its 
derangements ? and yet what empiric will you find impudent 
enough to claim an acquaintance with anatomy? If these men 
have the skill they profess to have, it must have come by inspira- 
tion. Are they usually such, in their lives and characters, as to 
render it probable that they would be selected as recipients of so 
high a favour ? Empirical medicines are often proclaimed to be 
infallible, and especially in diseases commonly deemed incurable. 
How does it happen, that the stigma of incurability still adheres 
to these diseases, notwithstanding the facility of resort to the 
remedy afforded by the philanthropy of its discoverer ? The 
very essence of quackery is the ascription to particular medicines 
of a sovereign power over particular maladies. Now, no disease 
is the same under all circumstances. It differs in its degree of 
violence, in its stages, in the constitution of the patient, in its 
complication with other affections ; so that the medicine which 
may prove remedial at one time, may act as a poison at another ; 
and substances possessed of any power whatever can never be 
empirically employed without risk of mischief. Besides, admit- 
ting for a moment the applicability of a particular medicine to 
the same disease under all circumstances, how is a correct 
decision to be obtained in relation to the disease itself? The 
most experienced physicians often find great difficulty in ascer- 
taining the precise character of cases which come under their 
notice : will not a person wholly uninformed be almost sure to 
err, and thus to use the medicine even where it may not be 
intended ? The aid of the regular practitioner cannot be sought 
for in forming the diagnosis, while the treatment is confided to 
the empiric. He knows too well what is due to himself, to the 
profession, and to the patient, to countenance in any way such 
vile impositions. It is true that quack remedies do not always 



148 ABUSES OF THE MATERIA MEDICA. 

destroy the patient ; but should they therefore obtain the credit 
of the cure ? If I knock a sick man down with a club, and nature 
is still powerful enough to restore him, is the result ascribable 
to the blow? The medicine may even accidentally do good. So 
will any drug on the shelves of the apothecary, if employed in 
all cases of disease. If every man who is unwell should take a 
dose of calomel, benefit would result in some instances ; but is 
that a sufficient reason for the indiscriminate use of calomel ? 
The cures, therefore, so abundantly paraded by the empiric, are 
false colours, stolen from nature or accident, and intended as 
lures to draw victims within his reach. The mischief which he 
does is left to the discovery of others, and is often concealed by 
the grave. 

These considerations, and many others which will readily 
suggest themselves to the physician, may be urged upon the 
good sense of those with whom he is socially or professionally 
connected, and will not be thrown away. Under such a course 
of proceeding, systematically and generally pursued, quackery 
would soon find itself excluded from the respectable walks of life. 
To eradicate the evil entirely will never be in our power. Its 
affinity for ignorance and folly is too strong to be overcome by 
any available force ; and until human nature is regenerated, 
ignorance and folly will not become extinct. 

I have thus endeavoured to conduct you through the round 
of abuses to which medicines are liable. There may be some 
which have escaped my attention, and much more might be said 
on many points which I have been compelled to touch upon 
but lightlv. You have, however, heard enousrh to satisfv vou 
of the importance of attending to the subject. My design has 
been to point out the means not only of properly regulating your 
own habits of prescription, but also of correcting, so far as the 
circumstances of the several cases will admit of correction, those 
numerous abuses on the part of irregular and empirical prac- 



ABUSES OF THE MATERIA MEDICA. 149 

titioners to which the public is exposed. In the Course which is 
about to commence, I shall have abundant opportunities of satis- 
fying you, that medicines, properly employed, are of indispensable 
necessity to the best management of disease ; and I apprehend, 
therefore, little danger, from the somewhat gloomy picture pre- 
sented to you, of any permanently injurious impressions on your 
minds in relation to the value of the materia medica. 



LECTURE V. 



DELIVERED NOVEMBER 8th, 1838. 



Mental Agency in the Treatment of Disease. 

I confess to you, gentlemen, that, often as I have stood before 
meetings like the present, I never address a newly assembled 
class unmoved. At the sight of so many familiar faces, seen 
after a long interval, and all beaming with kindly recognition, I 
cannot repress the gush of feeling that springs from the recol- 
lection of the past. But the future also has its share in the 
excitement of the moment. On the good-will and kindness — 
may I not say on the friendship of those who have so often be- 
fore listened to me from these seats, I rely with confidence j but 
there are many here for the first time, who come with unbiased 
feelings and judgment, and look to the future solely for their 
sentiments in relation to those under whose instruction they 
have enlisted. To these I cannot but turn with some solicitude. 
I know that a strict discharge of official duty will command their 
respect ; for the young heart is just. But their respect is not all 
that I desire. I wish also to possess their friendship. Between 
teacher and pupil a closer bond is requisite than that of mere 
duty or interest. I need not tell you how much better all work 
is done when the heart is in it. I need not tell you how much 
more lively and vigorous are the masculine faculties of the in- 
(150) 



MENTAL AGENCY IN THE TREATMENT OF DISEASE. 151 

tellect, how much brisker is memory, attention, judgment, reason, 
imagination, when cheered and inspirited by the lovely compan- 
ionship of the affections. Let the teacher act under the cold 
dictates of duty alone ; he may detail facts correctly, may collect 
all the essential materials, arrange them in due order, and lay 
them clearly before the student ; but how lifeless and unimpress- 
ive his manner ! How irksome alike to himself and his hearers 
the performance of his task ! But let the heart lend its impulses ; 
let the affections awaken in the breast of the speaker ; let him 
be animated by zeal for his subject, and a warm desire to 
please as well as instruct ; and then, how the eye brightens, 
how the whole countenance is lighted up, what life and soul 
breathe in the before languid utterance ! Words acquire new 
force when thus clothed in the tone and emphasis of feeling. 
Memory rouses up from her slumbers, and pours forth her stores 
of corroborative fact and incident. Imagination is stimulated to 
exertion, and gathers ornament and illustration from every field 
of nature. The contagion of enthusiasm spreads from the speaker 
to those around him ; the attention of the audience becomes ab- 
sorbed ; every word is understood and appreciated ; and a deep, 
accurate, and permanent impression is produced, instead of those 
vague and fugitive shadows of truth, which are often the only 
traces left in the memory by an uninteresting lecture. But there 
is nothing which contributes so much to animate the zeal of the 
teacher as the confidence that he enjoys the kind consideration, 
the good-will, the affection of his pupils. You will not, there- 
fore, think me unreasonable in asking for the favourable senti- 
ments of those among you to whom I am yet unknown ; in 
expressing my fervent wish that we may commence our labours 
as friends together, disposed to cheer and assist each other in. 
our progress, and to yield an affectionate sympathy under all 
circumstances. 

My business in this school is to teach materia medica and 



152 MENTAL AGENCY IN THE TREATMENT OP DISEASE. 

pharmacy. Od an occasion like the present, great latitude is 
usually allowed to the lecturer in the choice of his subject ; but 
there seems to be a propriety in maintaining* a degree of con- 
sistency with the general tenor of his lectures ; and it may be 
expected, therefore, that the remarks which I am about to make 
shall bear some relation to the branches of medicine just alluded 
to. In the most extensive application of the term materia 
medica, it may be said to embrace all the means, of whatever 
nature, employed in the cure of diseases. A course of lectures, 
however, which should attempt to exhaust the whole subject, in 
this ample sense, would occupy much more time than can be 
allotted to it in the arrangements of our school. The lecturer is 
necessarily confined, in the body of his course, to the considera- 
tion of medicines strictly so called ; and I always find that my 
limits are strongly pressed upon by the abundance of material 
even thus restricted. But, as some of the remedial means not 
included within these limits are highly important, it becomes 
proper in the teacher to avail himself of every opportunity, out 
of the ordinary course of his duties, to enforce their claims, and, 
so far as lies in his power, to make them familiar to his pupils. 
It is in accordance with this conviction, that I propose, in the 
present lecture, to occupy your attention with some remarks on 
mental agency in the treatment of disease. 

Of the existence of an immaterial principle distinct from the 
frame which it inhabits, I presume that few if any of you enter- 
tain a doubt. That mere brute matter, by any possible arrange- 
ment of its particles, should acquire the power of thinking and 
feeling, is a supposition so abhorrent to the common sense of 
mankind, that none but those who have become bewildered in 
the labyrinths of a false philosophy are likely to adopt or sup- 
port it. The belief of a soul within us, like that of a divinity 
above us, is the spontaneous result of the mental organization 
of our species, and, if it does not rank with our confidence in 



MENTAL AGENCY IN THE TREATMENT OP DISEASE. 153 

self-evident truths, is at least deduced from what we see and feel 
by a process of reasoning so short and simple as not to escape the 
feeblest intellect, and yet so strong as to resist, with the majority 
of minds, the most ingenious and forcible attacks of sophistry. 

How this immaterial principle is connected with the machinery 
which it keeps in motion, we know not, and, on this side of the 
grave, shall in all probability never know. That it is capable, by 
an excessive, deficient; or deranged influence, of throwing the 
machinery itself into disorder, might be inferred a priori, and is 
abundantly proved by experience. Accordingly, in every treatise 
on practical medicine, we find moral causes enumerated among 
those most fruitful in the production of disease. To instance 
only a few examples ; what physician is ignorant that violent 
anger may give rise to apoplexy ? that sudden emotions, whether 
of joy or grief, may suspend for a time, if not altogether arrest, 
the motions of the heart ? that continued mental excitement is a 
not unfrequent cause of inflammation of the brain ; and mental 
depression, of dyspepsia, chronic hepatitis, and various other 
forms of visceral derangement? that, finally, in the delicate 
female, the sensitive nerves often respond in hysteria and con- 
vulsions to the rude touches of anxiety or vexation, while even 
the iron cords of man's constitution sometimes melt before the 
flames of love ? 

But from a fountain thus overflowing with evil, may we not 
also draw something that is good ? If mental influence is often 
found among the causes of disease, may it not also be sometimes 
used as an instrument of cure? To think otherwise would 
be doing injustice to that kind order of Providence, which has 
instilled something that is sweet into every cup of evil, which 
has ever made those roses the most fragrant that are accom- 
panied with thorns. There can be no doubt that a skilful phy- 
sician may often very advantageously enlist the aid of the mind 
against the bodily ailments of his patients. 



154 MENTAL AGENCY IN THE TREATMENT OP DISEASE. 

To give a complete view of all those therapeutical means 
which might rank tinder the head of moral remedies, and an 
exact detail of the best modes of applying them, even were time 
allowed me, would greatly exceed any ability which I may pos- 
sess ; for the nature of mental action is often so subtle as to defy 
scrutiny, and its varieties so infinitely numerous that no patience 
could record them ; and yet, there is scarce one of these flitting 
movements which, if seized at the proper moment, may not be 
made available in the cure of disease. The cultivated and ob- 
servant physician, who is ever on the watch for assistance, and 
has his mind turned as well to the moral as the physical 
agencies within his reach, will constantly find opportunity in his 
path ; and common sense will teach him how best to use it. All 
that I can at present do, is to endeavour to render you duly sen- 
sible of the importance of this kind of aid, and to bring before 
your notice a few facts and considerations, as points about which 
your own reflections may cluster. Every mind sends out its 
crowd of thoughts in all directions ; what it most needs is a spot 
in which the swarm may gather, and thence proceed to labour 
in the great task of collecting riches and sweets from the flowery 
world around them. 

The feelings, emotions, and passions are perhaps those parts 
of our mental constitution which are most available for remedial 
purposes. It should always be borne in mind by the physician, 
that of these some have an excitant and others a depressing 
influence, and, when brought into play therapeutically, must be 
made to bear upon opposite states or tendencies of the system. 
Thus, all the modifications of joy, hope, anger, and the feeling 
of the ludicrous, are more or less stimulant, and, in their various 
grades of intensity, produce every degree of excitement, from 
the gentle glow of self-complacence, up, through the fever of 
succeeding or successful enterprise, to the delirium of rapturous 
enjoyment, or the overwhelming tumult of fierce and sudden 



MENTAL AGENCY IN THE TREATMENT OF DISEASE. 155 

wrath. Grief and fear, on the contrary, in their almost infinitely 
diversified grades and forms, diminish the energies and depress 
the actions of the system, and are even capable, in their excess 
of despair and terror, of producing fatal prostration. 

These different effects, in their relation to disease, we some- 
times see exemplified, on a large scale, in the extraordinary 
prevalence of health during the invigorating influence of national 
prosperity, and in the low typhoid epidemics which are so apt to 
march in the rear of national distress. The resistance which that 
condition of the system, resulting from a cheerful and confident 
state of mind, affords to the assault of prevalent maladies, 
and the contrary effects of a fearful and gloomily foreboding 
temper, are familiar to all who have lived through a season of 
pestilence. The terror, which goes forth before the deadly epi- 
demic, prepares the way for its devastating march. Why does 
pestilence so often respect the physician, but that it quails, like 
the tiger, before a cool and undaunted eye ? 

There are certain passions of a complicated nature, which 
produce different and even opposite effects on the system, accord- 
ing as one or the other of their phases is presented. Thus, we 
have love with its joys and its hopes on the one hand, its sor- 
rows, fears, anxieties, and disappointments on the other ; jealousy 
and revenge, now pining with their griefs, and now intoxicated 
by their hateful anticipations or accomplished wishes ; ambition 
with its fiercely exciting triumphs, its prostrating failures, and 
its anxious, harassing uncertainties ; and so with numerous other 
modes of feeling, which, if not essentially complex, are neces- 
sarily associated with varying emotions, through which they 
variously affect the state of health. Their effects, however, may 
in general be resolved into those of excitement and depression, 
such as result from the simpler feelings of pure joy and grief. 

The wise physician will have regard to all these influences in 
the cure of disease. It is true that he cannot always command 



156 MENTAL AGENCY IN THE TREATMENT OP DISEASE. 

them at will. He cannot prescribe them as he would a dose of 
medicine, or the loss of blood. They are, for the most part, the 
creatures of opportunity, and he must be ready to seize them as 
they appear. Often do they fly up suddenly and unexpectedly 
before his steps; and, like a good sportsman, he must be prepared 
to take them on the wing. 

Of the more violent forms of feeling, the chances of a beneficial 
application are comparatively rare. They cannot usually be long 
maintained ; and, in most diseases to which they would other- 
wise be applicable, whether of an elevated or feeble character, 
injury instead of benefit might result from their transitory stimu- 
lation or depression. There are, however, occasions in which 
we may advantageously call in their aid. When the disease 
itself is of a quick onset and fugitive nature, the violent shock 
of passion will sometimes roll back its surges, and leave the 
patient safe. In instances of high nervous excitement, threaten- 
ing convulsions perhaps or mania, a strong impression of terror 
or of grief will sometimes quell the agitated nerves, and compel 
them to peace. The paroxysms of hysteria may often be turned 
aside by preoccupying the mind with the fear of some approach- 
ing evil. The excitement of some strong emotion may also be 
advantageously resorted to, in certain cases of morbid apathy 
which bid defiance to medicines. In such cases, the physician 
may sometimes lay the foundation of lasting gratitude from the 
patient, by purposely rendering himself for a time the subject of 
his anger. 

But much more useful results can be obtained from the milder 
emotions, which are more at our command, may be applied with 
less hazard to the patient, and can be much longer sustained. 
The supporting and even remedial influence of a cheerful, confi- 
dent, hopeful state of mind, in low and protracted diseases, must 
be familiar to every observer. Hence, in our profession, the 
importance of manner to success, not only in the attainment of 



MENTAL AGENCY IN THE TREATMENT OF DISEASE. 157 

business, but also in the discharge of duty. The medical prac- 
titioner who, considering his patient as a mere piece of deranged 
machinery, enters the sick room as he would a work-shop, and 
hammers away at the disease like a blacksmith or a carpenter ; 
who, taking no account of mental influence, talks by the bedside 
as he would elsewhere, and blurts out views and anticipations 
without reference to the anxieties, the wishes, or fears of the 
invalid, must frequently find himself at fault in his calculations, 
must constantly witness injurious interferences in his plans 
which he cannot explain, and encounter results contrary to his 
hopes and predictions, and strongly adverse to his reputation. 
A cheerful mien, an affectionate deportment displaying and at 
the same time inspiring interest, a kind and studious attention 
as well to the wishes and even caprices of disease as to its claims, 
a mild forbearance in cases of irritability, peevishness, or fretful- 
ness, with a disposition rather to soothe into quietness than 
forcibly to repress these morbid nervous irregularities ; such are 
the means which the physician should apply, in order to produce 
and sustain in his patient that trusting, grateful, satisfied state 
of mind, so powerfully auxiliary to a course of medical treatment. 
He should also, whenever he can do so conscientiously, bring in 
to his aid the cheering influence of hope, and, if suitably gifted 
by nature, may superadd the gentle excitement of humorous and 
entertaining conversation, kept within the bounds of discretion. 
He should, moreover, endeavour so to regulate the circumstances 
in which the patient may be placed, in the intervals of his visits, 
as to maintain steadily this pleasing current of thought and feel- 
ing. In chronic cases of disease, especially those in which the 
digestive organs are materially interested, the aid of such mental 
influence is peculiarly requisite. Hence in part it is, that a 
patient long confined to his chamber, or to the narrow walks of 
a crowded city, often throws off at once the load of disease, when 
permitted to breathe the free air of the country, to drink in the 



158 MENTAL AGENCY IN THE TREATMENT OF DISEASE. 

delicious yet calm enjoyments of rural beauty, and to allow his 
mind, released from the anxieties of business, or the turbulence 
of ambition, to wander at will wherever fancy may conduct it, 
and gather in joy, and admiration, and gratitude, and a host of 
other agreeable or profitable emotions from the rich abundance 
of nature. Rural sports, the easy and unrestrained intercourse 
and the quiet amusements of our watering places, the various 
adventure and diversified scenes of travel, by the agreeable 
excitement which they sustain in the mind of the invalid, con- 
tribute scarcely less than exercise and pure air, and much more, 
I believe, than the vaunted virtues of the waters, to those 
striking cases of amendment or cure which result from a journey 
to the different mineral springs of our country, so much the 
resort of fashion, debility, and disease. 

In relation to the beneficial influence of hope, and the prostra- 
ting effects of anxiety and fear upon the health of patients, es- 
pecially in chronic disorders, or in the declining stages of such 
as are acute, it often becomes a question for the conscience of 
the physician to determine, how far he may be justified in de- 
ceiving the patient, in cases of danger, as to his real condition, 
and thus turning off his mind from that preparation which it 
becomes every one to make for the awful future that awaits him. 
There are not wanting individuals who rank it among the duties 
of medical men, to assume the charge of the spiritual as well as 
bodily interests of their patients, and like faithful watchmen to 
warn them of the approach of danger. Such a course would, I 
honestly believe, frequently realize a danger which might other- 
wise exist only in apprehension ; and the physician, who should 
thus step out of the path of his own peculiar duties, ought not 
to be held guiltless of the very serious results which might en- 
sue. I have always deemed it my duty, when the symptoms of 
a disease have taken on an alarming character, to make the rela- 
tives or near friends of the patient aware of his real condition, 



MENTAL AGENCY IN THE TREATMENT OF DISEASE. 159 

in order that they may have an opportunity for taking such steps 
as they may deem proper; but, even in such cases, when asked 
my opinion as to the propriety of informing the patient himself, 
I have had no hesitation in advising silence, whenever it has ap- 
peared to me that the alarm and agitation, consequent upon a 
contrary course, might greatly increase the hazard of an un- 
favourable issue. If they who are so fearful lest an individual 
may go out of the world ignorant of his condition, and with all 
his unrepented sins upon him, would consider that, in severe and 
acute disease, the mind is seldom in such a state as to be capa- 
ble of the great work "of reformation, and that, in attempting to 
do a very doubtful good, they incur the hazard of producing a 
fatal result, otherwise perhaps avoidable, and thus precipitating 
the patient into the very danger which they were most anxious 
to shun, they would be more cautious of interfering themselves, 
and less urgent upon the physician to assume so tremendous a 
responsibility. When the disease is necessarily fatal, and no 
management of the hopes and fears of the patient can materi- 
ally affect the issue, the case assumes an exclusively moral char- 
acter, and the physician should never stand in the way of such 
a course of proceeding as may seem best to those most nearly 
interested, nor, from a weak fear of giving pain, withhold that 
knowledge to which they have an undoubted right. There are, 
moreover, occasional cases, in which the probability of injury to 
the patient may be so far overbalanced by the probability of good 
from his knowledge of his exact position, that the physician can- 
not properly become instrumental in giving or encouraging a 
false impression ; and there are others, in which he may well 
hesitate as to the proper course : but, as a general rule, the plan 
of cheering and encouraging the patient, of turning his attention 
to the bright side of his prospect, of soothing his anxieties and 
fears, and removing as far as possible every agitating reflection, 
is as much the duty of the medical attendant, in doubtful cases 



160 MENTAL AGENCY IN THE TREATMENT OP DISEASE. 

of illness, as to keep away every noxious physical agent, and to 
apply every suitable physical remedy. 

Our attention has hitherto been directed to those states of the 
mind in which it is usually considered passive, and under the 
influence of which the corporeal functions are either stimulated 
or depressed. There is another mental condition, which, as it is 
the result of causes usually not under the direction of the will, 
may also be considered passive, and which, though neither es- 
sentially stimulating nor depressing, exerts, however, a power- 
ful influence for good or ill over the health ; I allude to the feel- 
ing of belief or faith, which you will all recognize as one of the 
most energetic principles of human action. That the simple ex- 
istence of a firm belief is sufficient to bring about, in many in- 
stances, the event or condition of things believed, is among the 
best established truths in the history of the mind. Most of you 
must have heard of the familiar fact, that our native Indians, 
under the fatal prophecies of their priests or sorcerers, sometimes 
pine away and die ; and dreams and visions foreboding misfortune 
or death have realized themselves through the credulity of their 
subject. It is true that belief operates, in general, not by an im- 
mediate influence on the system, but through the instrumentality 
of other principles which it brings into action. Thus, when the 
object of belief is of a pleasing or fearful nature, joy in the one 
case, and terror in the other, become the immediate agents of 
the result ; and in both cases, as well as where the object is 
quite indifferent, the imagination is often called powerfully into 
play ; and awe, wonder, the vague feeling of the mysterious, and 
various other emotions lend an effective aid. Still, faith is at 
the foundation of the whole ; and it is to this principle that the 
physician is to direct his efforts. Hence the importance of in- 
spiring our patients with confidence in our skill, and wish to 
serve them. Thus aided, our prognostications will often fulfil 
themselves, and our prescriptions will operate with a double 



MENTAL AGENCY IN THE TREATMENT OP DISEASE. 161 

force. Most medicines will produce their peculiar effects with 
greater certainty, if the patient be previously made acquainted 
with these effects ; and it sometimes happens that, through the 
agency of faith alone, the operation of medicines may be imitated, 
even though not a particle may have been swallowed. It is thus 
that we may explain many of the phenomena which attend the 
homoeopathic practice. I have heard of profuse salivation in- 
duced by a dose of mercury, so small as to be invisible to the 
naked eye. Mercury has been sometimes called the Samson of 
the materia medica ; but I have no doubt that faith was in this 
instance much the stronger of the two. An anecdote was not 
long since related in my presence, somewhat illustrative of the 
principle under discussion. A nervous female, having been at- 
tended for a considerable time, with less benefit than she ex- 
pected, by a young physician, became at length impatient, and 
proposed to her attendant that he should give place to a homoeo- 
pathic practitioner. The physician acknowledged the inemcacy 
of the means hitherto employed, but spoke of a new remedy 
which had been sometimes attended with very beneficial results,. 
and advised a trial of it in the present instance. It was to be 
introduced into a glass bottle, and the patient was to smell of it 
very cautiously a given number of times for nine successive 
days, taking care to observe, with rigid accuracy, various direc- 
tions of a trivial nature which were given at the same time. 
On certain days it was to produce certain effects, among which, 
I recollect, was a diarrhoea ; and on the ninth day the cure was to 
be accomplished. The patient seized on the idea with avidity ; 
and the medicine was accordingly soon provided. I hardly need 
inform you that the bottle, though well stopped, contained in 
fact nothing but atmospheric air. The directions were strictly 
complied with; and, at the expiration of nine days, the physi- 
cian called to learn the result of his new practice. He was 
happy to be informed that his patient was quite well, that his 

11 



162 MENTAL AGENCY IN THE TREATMENT OF DISEASE. 

medicine had operated charmingly, and that the effects had taken 
place in their due succession, exactly as he had foretold them, 
diarrhoea and all. On the influence of faith, therefore, gentle- 
men, I would advise you to calculate largely, and never to lose 
a fair opportunity of securing its co-operation, when you can do 
so with a due regard to the feelings and character of the patient, 
to truth, and to your own reputation. 

The intellectual faculties, with the single exception of the im- 
agination, as they less observably affect, in their exercise, the 
functions of the system, are less available remedially than the 
mental conditions already alluded to ; but the physician cannot 
safely leave them out of his estimate, either in weighing the 
causes of disease, or in considering the means of its cure. It is 
a well-known fact, that a too vigorous or protracted exertion of 
the intellect is attended with the danger, first, of over-exciting 
and iuflaming the brain, and, secondly, of abstracting the due 
supply of nervous influence from the digestive organs, and thus 
giving rise to dyspepsia and all its train of evils. When such 
effects come under the notice of the physician, or good reason 
exists to apprehend them, he will of course recommend a tem- 
porary relaxation, or total abstinence, according to the degree of 
the injury or danger. 

But there are also cases in which he may advantageously re- 
sort to the active faculties of the mind as positive aids. In 
many instances, the suspension of mental effort, after one has 
been long accustomed to it, leaves an individual languid, un- 
easy, restless. He feels the absence of a wonted excitement, 
takes no interest in the objects around him, becomes depressed 
in spirits and often a prey to hypochondriacal feelings and 
notions ; and at last, under the influence partly of mental de- 
jectiou, partly of those habits to which it is apt to lead, his 
bodily health gives way, and the physician is called in to cor- 
rect the evil. Such is very commonly the case with men, who, 



MENTAL AGENCY IN THE TREATMENT OP DISEASE. 163 

having spent a great portion of their lives in a constant and 
laborious pursuit of fortune, of fame, or of both, and, having at 
length succeeded, determine to retire, and devote the remainder 
of their days to quiet enjoyment. The only effectual remedy, 
in such cases, is to bring the intellect again into action, either in 
the original pursuit, or, if that has lost its charms, in some 
other adapted to the tastes and talents of the individual. 

Of the intellectual faculties, the imagination is, beyond com- 
parison, that with which the physician is most concerned, which 
he can wield most effectively against disease. In saying this 
much, I do not by any means assent to that very common error 
of language, which ascribes to this faculty all the extraordinary 
pathological results which occur through mental agency. If an 
individual faints at some painful intelligence, or sinks into a 
wasting disease under the influence of misfortune, or goes dis- 
tracted with joy, or falls into hysterical convulsions when vexed 
or irritated, it is assuredly not the imagination which is to 
blame ; nor does this principle deserve the credit of the cure, 
when a neuralgic pain ceases through the operation of a well- 
founded fear, or an intermittent is suspended, as it sometimes is, 
by the mere agency of a rational faith. By the imagination we 
mean that faculty of the mind which brings before it images of 
things past or absent, or without prototype in nature, throws 
simple ideas into every variety of association not sanctioned by 
reason and judgment, discovers analogies and relations between 
objects which have no actual connection, and gives at the same 
time the force of truth to its unreal fancies. Scarcely any 
bounds can be assigned to the influence of such a faculty for 
good or for evil. There is not an emotion of the human breast 
which it may not call into action ; for it may place before the 
mind the pictures of things calculated to impress it in any way 
in which it is impressible, and may then impart to these pictures 
all the characters of reality. It is capable, therefore, of pro- 



164 MENTAL AGENCY IN THE TREATMENT OF DISEASE. 

during on the health, indirectly, whatever effects can flow di- 
rectly from other mental sources. It is the great instrument by 
which empiricism, at all times and in all places, among the sav- 
age and the civilized, has operated upon the credulity of mankind. 

The regular physician, however, is much more limited than 
the empiric in the use which he can make of this principle. Re- 
gard to his own reputation and to the credit of his calling, as 
well as to the general claims of truth, forbid fraudulent decep- 
tion ; and the convenient cloak of ignorance is wanting, under 
which he could conscientiously spread false impressions, because 
himself deceived. But it naturally happens, that a patient im- 
agines more virtue in a medicine, or more efficacy in a course of 
treatment, or more skill in his attendant than the reality would 
warrant; and the physician would do wrong in depriving him 
of the advantages of this impression, from an abstract regard for 
truth. He may, I think, often go further than this, and stimu- 
late somewhat the patient's imagination when it flags, without 
any compromise of the great interests of morality ; and, in cases 
where nervous derangement has impaired or destroyed the power 
of correct judgment, he may take the reins wholly into his own 
hands, and guide the thoughts and feelings of the invalid into 
whatever channels he may deem most conducive to good. 

In an account of the mental influences capable of remedial 
application, we should not omit the fact, that any strong impres- 
sion on the mind, of whatever nature, will often suspend or 
entirely remove disease. This is particularly the case, when 
the complaint is purely nervous, or, if attended with inflamma- 
tory symptoms, is of that volatile character which prevents it 
from fixing firmly on any one part of the frame. Intermittent 
diseases are also peculiarly submissive to this mode of cure. 
The chain of concealed morbid action which, probably, in these 
cases, runs through the intermission, is broken by any powerful 
impression on the system, whether made through the agency of 



MENTAL AGENCY IN TIIE TREATMENT OF DISEASE. 165 

the mind or otherwise; and the paroxysm which hangs upon 
it consequently falls. Sudden surprise, intense wonder, a feeling 
of the mysterious and awful, any of the stronger passions called 
into quick and powerful exercise, high excitement of the imagina- 
tion, a very close and absorbing application of the attention or 
reasouing powers ; any one of these causes, and still more cer- 
tainly a number of them combined, is capable of so impressing 
the brain and nervous system generally, as to displace disorders 
having their root in this system, by substituting a new and 
incompatible action. 

Instances are scarcely necessary to illustrate this truth. You 
have all read of the dumb, who, under the influence of some irre- 
sistible call for the exercise of their lost faculty, have suddenly 
been restored to speech. The gouty man has* found the use of 
his inflamed feet, and the paralytic of his palsied limbs, when 
their aid has been necessary to remove their possessor from some 
immediate and fearful danger. Who has not seen hiccough 
vanish before a sudden access of terror or surprise? Neuralgia 
has yielded a thousand times to the complicated emotions, attend- 
ant upon certain empirical and highly pretending processes of 
cure. A seventh son, who, as is well known, has a divinely 
derived power of healing, prescribes for an obstinate ague ; and 
the sense of the supernatural, which spreads through the mind 
of the patient, proves more than a match for the disease. A 
natural bonesetter stands by the bedside of a nervous female, 
long confined by a sprained and neuralgic ankle ; he declares the 
existence of a dislocation, and performs some trifling manipula- 
tion about the part; the pain vanishes before his mysterious 
touch ; the patient rises at his bidding, and finds to her astonish- 
ment that she can walk. The wonderful cure goes forth to swell 
the fame of the inspired operator, and adds to his power over 
succeeding cases. An Indian doctor, redolent of whisky, regards 
with solemn stolidity some superstitious subject of the colic, and 



166 MENTAL AGENCY IN THE TREATMENT OF DISEASE. 

mutters his supernatural charms. The disorder passes from the 
weak bowels of the patient to his weaker brain ; and a cure is 
effected. The homceopathist visits some recent martyr to palpi- 
tation of the heart ; he looks wisely, scrutinizes closely, ques- 
tions minutely about all manner of things, and, having put the 
mind into a delirium of various agitation, prescribes the millionth 
of a millionth of a grain of some medicine which he deems appro- 
priate, and departs. At his next visit he finds his patient well, 
and gives glory to Hahnemann. I might go on multiplying 
instances indefinitely ; for they are as numerous as the diversities 
of credulous ignorance and folly on the one hand, and of knavish 
cunning, superstitious self-conceit, and intellectual hallucination 
on the other. The physician, it is true, can seldom condescend 
to these doubtful methods of cure ; and yet there may be occa- 
sions in which he may, with propriety, take advantage of the 
principle, and endeavour to control or subdue the disease by the 
excitement of some strong but short-lived mental disturbance. 

It remains only that we should inquire, whether there are not 
certain mental states or actions which may be employed reme- 
dially in reference to their secondary effects. At the present 
moment, nothing of the kind occurs to me, unless we may rank 
under this head those psychological phenomena which have 
recently attracted so much notice, as the result of the so-called 
animal magnetism. I am not among those who are disposed to 
throw unmitigated ridicule upon this much-agitated subject. In 
the supernatural aspect which has at various times been given 
to it by the ill-regulated imagination of some of its warmer vota- 
ries, it merits only silent contempt. When miracles are urged 
upon our belief, we may, with great propriety, decline listening 
even to offered proof, unless there be presented, at the same time, 
an end sufficiently important to justify their performance. We 
may rest assured that the great physical laws of nature are never 
violated, in order to give notoriety to a few hysterical females 



MENTAL AGENCY IN THE TREATMENT OF DISEASE. 167 

and their managers, or amusement to a few idle lookers-on. But, 
while we utterly refuse credence to all that is miraculous in 
animal magnetism, let us not go to the opposite extreme, and 
reject, without examination, all within the bounds of possibility 
that is asserted of its powers. That many individuals, particu- 
larly those of excitable nerves, are thrown into a peculiar de- 
ranged condition of the system, under the influence of processes 
brought to bear upon them by the magnetizers, is a fact at 
present, I think, too well established to admit of reasonable 
denial. This deranged condition is usually spoken of as sleep ; 
but it differs from ordinary sleep in some important particulars, 
and approaches more nearly to that state of the nervous system, 
which has been known under the name of somnambulism. The 
hands are generally cool and moist, the face more or less flushed, 
and the pulse increased in frequency. The senses are variously 
affected ; but in general the susceptibility to painful impressions 
is greatly diminished ; while the hearing, sight, and touch, espe- 
cially the latter, are often unimpaired, and sometimes rendered 
even more acute than in the waking state. I do not pretend to 
give a full description of this disordered condition, and have 
alluded to the few points just mentioned only in order to show 
that it is not identical with natural sleep. The question at 
present is, whether its phenomena are induced merely through 
the influence of the nrind of the individual affected acting on his 
nervous system, or whether, as the advocates of animal magnet- 
ism considered as a distinct branch of science suppose, the effect 
results from the physical agency of the nervous system of the 
operator upon that of the subject of the operation, as a magnet, 
or an excited electric, affects other bodies in its neighbourhood. 
The latter mode of action is certainly not without the limits of 
possibility, that is, involves no possible contradiction of estab- 
lished laws of nature ; and they who, in a philosophical spirit, 
investigate the subject with a view to the discovery of truth, so 



168 MENTAL AGENCY IN THE TREATMENT OF DISEASE. 

far from meriting ridicule or censure, are entitled to our respect, 
if not commendation. But, in the present state of the question, 
I am decidedly inclined to the opinion, that all the phenomena 
of animal magnetism are best explained upon the exclusive 
ground of the mental agency of the individual affected. My 
reasons for this opinion are chiefly, first, that it is unphilosophical 
to seek for a new power to explain phenomena, which are at all 
explicable upon well-known and established principles ; and, 
secondly, that, taking all the well-ascertained facts into consid- 
eration, they accord better with what we already know of the 
influence of the mind over the corporeal actions, than with any 
hitherto discovered physical influence, or even with any which 
has been invented by the fruitful imagination of Mesmer and his 
followers. 

It is impossible for me, in the very few minutes which remain, 
to develop fully my ideas upon this subject. I will only, for a 
moment, call your attention to the circumstances under which 
the peculiar phenomena of animal magnetism are usually pro- 
duced, and thereby afford you some slight ground for a judgment 
in relation to the question at issue. The individuals susceptible 
of the influence are usually persons of a weak or excitable nervous 
system, such as children or delicate females, whose cerebral 
functions mav be thrown into disorder bv slight causes, and 
whose minds are not strengthened by matured reason or judg- 
ment against strange, extravagant, or superstitious fancies. The 
operator is in general a man, often of fine physical developments, 
and almost always of a decidedly superior cast, either mentally, 
bodily, or by station, to the person upon whom he operates. 
Conceive now a subject such as I have described, a hysterical 
woman, or a delicate little girl, for example, placed before an 
individual of the opposite sex, of a vigorous frame and expressive 
features, who regards her with a serious, fixed, and to her inex- 
plicable air, as if looking into her most secret thoughts, and con- 



MENTAL AGENCY IN THE TREATMENT OF DISEASE. 169 

fident of a commanding power over her feeble spirit, placing his 
hand mysteriously upon her head or brow, putting his thumbs 
into a still more mysterious contact with hers, and making 
certain magical movements about her, as if to bring her system 
within the circle of some supernatural influence ; — what condition 
of things could be conceived more likely to put the nervous 
system into disorder, and to produce some of those strange phe- 
nomena of which such disorder is the fruitful root? A highly 
excited curiosity, an almost fearful wonder, a feeling of awe as 
in the presence of some mysterious power, an imagination thrown 
into the wildest confusion, and yet repressed by the stronger 
emotions of the moment — these, with perhaps other vague and 
undefinable agitations, interrupt the regular functions of the 
brain; and, by a wise provision of nature, the individual, by 
becoming insensible of her condition, and of the circumstances 
around her, is released from a disturbance which might other- 
wise, perhaps, result in unpleasant effects upon the health. 
There is certainly nothing more wonderful in this than in the 
fainting which so often supervenes upon any sudden and very 
important intelligence, or the hysterical convulsions resulting 
from any disagreeable excitement. The latter phenomena are 
more familiar, because their causes are more frequently brought 
into operation. The magnetic sleep, as it has been called, would 
not seem more strange, were the circumstances that induce the 
peculiar complex state of mind in which it originates, of ordinary 
occurrence.* 

* I would here refer to an essay, by the late John K. Mitchell, M.D., 
professor of the practice of medicine in the Jefferson College, of Phila- 
delphia, giving the results of his investigations and experiments in 
reference to animal magnetism, as containing much interesting informa- 
tion on this subject. The essay has been published since his death 
(Philadelphia, a.d. 1859) by his son, S. Weir Mitchell, M.D., with 
several other essays, constituting a valuable collection of the more import- 
ant contributions of the author to general and medical science. 



1*70 MENTAL AGENCY IN THE TREATMENT OF DISEASE. 

You perceive that, viewing animal magnetism as I do, it would 
not have been proper for me to omit noticing it in an account 
of mental agency in relation to therapeutics. There can be no 
doubt, that a condition of system of so decided a character as that 
which has been engaging our attention, and capable of being 
induced, in many instances, with great certainty and precision, 
may be occasionally resorted to with advantage in the treatment 
of disease. The fact is, I think, beyond question, that the sensi- 
bility to painful impressions is sometimes greatly diminished 
during this state, so' that surgical operations may be performed 
without rousing the patient. Many of you have heard of Clo- 
quet's famous case, in which a cancerous breast was amputated, 
without the consciousness of the patient operated upon; and 
in many instances teeth have been extracted without apparent 
pain. The advantage thus afforded to surgery is obvious; as 
the very persons most easily brought into the condition of di- 
minished sensibility to pain, are those in whom such a condi- 
tion would be most desirable in anticipation of an operation. 
Another beneficial application of this indirect mental agency is 
to the relief of morbid vigilance, and of various distressing nerv- 
ous disturbances, in which it may possibly produce at least 
temporary good. But we are yet in want of sufficient precision 
in our knowledge of the phenomena of animal magnetism, to en- 
able us to employ them therapeutically with the requisite confi- 
dence. Truth is so mixed up with error in the reports upon the 
subject ; an almost delirous wildness of imagination, and a very 
discreditable charlatanry, have so much sophisticated the sober 
researches of philosophy, that it is utterly impossible, in the 
present state of the subject, to deduce any precise and satis- 
factory conclusions from the mass of materials presented to us. 
It may be that precision is unattainable ; but at least the pursuit 
of it ought not to be deemed visionary or absurd ; and should 
any plain and satisfactory results flow from the researches of 



MENTAL AGENCY IN THE TREATMENT OF DISEASE. 1 T 1 

individuals engaged in this pursuit, whatever may be the issue 
in relation to practical good, they will merit and obtain the last- 
ing applause of the scientific world. 

With these remarks I close a slight sketch of a very ample 
subject. It was not originally my intention to occupy so much 
of your time ; but the few points which presented themselves at 
the first glance, and seemed scarcely susceptible of sufficient ex- 
tension to fill even the small space of a single lecture, spread 
themselves out under examination ; so that my only difficulty 
has been to repress them within due limits. Should I have 
transgressed as much on your patience as your time, I have 
reason to be gratified by a forbearance, which I sincerely hope 
will be continued to me throughout the arduous duties of the 
coming winter. In the discharge of these duties I engage to 
you the best of my abilities ; and I repeat, in conclusion, a wish 
expressed in the commencement of the lecture, and which is 
seldom absent from my thoughts, that we may go on harmoni- 
ously together, yielding mutual countenance and aid, and dis- 
posed to extend to each other a friendly partiality, when the 
claims of rigid justice may be silent. 



LECTURE VI. 



DELIVERED NOVEMBER 2nd, 1842. 



On (he Choice of Medicines. 

We are assembled, gentlemen, to enter upon a course of ardu- 
ous labour. Those of you to whom the occasion is quite new, 
scarcely stand in need of encouragement. The ardour of a com- 
mencing enterprise is glowing in your breast ; and the prospect 
of difficulties but animates you, as it offers scope to energies 
which are panting for action. But there is almost always some- 
thing distasteful in renewed exertion, after a period of temporary 
rest. They, who have once or oftener struggled through the 
torrent of various labour that now crosses your path, may well 
be excused if they experience a slight shudder upon again ap- 
proaching its brink. But it is only the first plunge which you 
have to dread. It is true that, if alarmed, like a child on his 
first attempt at bathing, you enter hesitatingly into the chilling 
wave, first introducing one foot and then the other, and cau- 
tiously increasing your depth as you advance step by step, you 
may become benumbed and disheartened before you have had 
the opportunity for exertion ; but leap at once into the midst of 
your duties, strike out energetically with all the vigour you pos- 
sess, and the first shock will soon be followed by an agreeable 
glow of reaction ; the consciousness of faculties exercised, and 
(172) 



ON THE CHOICE OP MEDICINES. 173 

useful ends fulfilled, will spread a grateful satisfaction throughout 
your mental frame; and you will experimentally feel the truth, 
that, though man has been condemned to earn his bread by the 
sweat of his brow, yet a kind Providence has lightened the inflic- 
tion, by inseparably attaching a feeling of pleasure to every act of 
profitable labour. I may, therefore, congratulate you, gentle- 
men, as well as cordially welcome you on this occasion. I need 
scarcely say, that it will be both my duty and pleasure to facili- 
tate your labours, and increase their productiveness by all the 
means in my power. Even in the present address I shall keep 
this object in view, and, while introducing the general subject of 
my course to your notice, shall endeavour to give you certain 
views which may be of some practical utility. 

You are aware that my department in this school is that of 
materia medica, or the science which treats of medicines. The 
time allotted, in the arrangements of the school, to the course of 
lectures on this subject is so completely filled up by practical de- 
tails, that little or none is left for considerations of a general 
nature, for which, therefore, I am compelled to seek opportunity 
in my introductory addresses. Through these, accordingly, I 
have endeavoured to present to the notice, and press upon the 
adoption of the student, various facts, sentiments, and principles, 
having a more or less close relation to materia medica, and a 
more or less important bearing upon its successful application to 
practice ; yet not exactly suited to the body of the course. I have 
thus, in different lectures, given sketches of the general history 
of materia medica, and of its particular history in the United 
States ; observations upon the relative importance of the science, 
and its claims on the attention of the student; an account of the 
more frequent sources of error and abuse in its practical applica- 
tion ; and a dissertation upon the advantages of a therapeutical 
recourse to moral influences as auxiliary to the physical. In 
continuation of the same plan, I propose at present to offer 



1T4 ON THE CHOICE OP MEDICINES. 

to the class some considerations upon the proper choice of 
medicines. 

The fact which, perhaps, strikes most strongly the commencing 
student of materia medica, is the great number of substances 
which, either as crude medicines or pharmaceutical preparations, 
swell the catalogues of authors, and load the shelves of the 
apothecary. From the first experience of pain and sickness, 
mankind probably began to look around into nature for sources 
of relief, and to accumulate substances of real or supposed cura- 
tive efficacy. The continuance of the evil has ever since sus- 
tained the search ; and an almost uninterrupted stream of con- 
tributions has been and continues to be poured into the mighty 
reservoir of therapeutics. In the earlier ages, substances deemed 
inefficacious, after a sufficient trial, were probably consigned to 
entire oblivion ; but those which the physician now rejects or 
abandons are received and preserved in the records of the press, 
ready to meet the researches of some future explorer, and again 
to run a brief course of popularity, as newly discovered reme- 
dies. The love of distinction, the hope of profit, and the necessi- 
ties of an over-crowded competition, are constantly co-operating 
with the laudable desire of doing good, to bring forth new medi- 
cines, or new modifications of old ones ; and invention is tortured, 
not more in the production of the novelty, than in the collection 
or creation of plausible evidence in its favour. Though happily 
but a few centuries distant from the commencement of this more 
rapid course of accumulation, we have already, as may be seen 
by consulting the index of the Pharmacopoeia Universalis, a list 
of something like twenty thousand medicines and preparations, 
more or less different from each other, recognized by the col- 
lective modern standards. What is to be done, a few centuries 
hence, if this respectable list shall go on increasing in the same 
ratio, we must be content to leave, together with many other 
equally puzzling questions, to the decision of posterity, whom 



ON THE CHOICE OF MEDICINES. 115 

they especially concern. For us it is sufficient to bear our own 
burden, and to take care that its magnitude do not overwhelm 
us. It must be obvious to you that, after having thrown nine- 
teen parts out of twenty of this enormous mass away as utterly 
useless, it will still be necessary to make a cautious selection out 
of the remainder, in order to bring it within a manageable com- 
pass. The young practitioner, who has as yet had little expe- 
rience of his own, will necessarily be guided, to a great extent, 
by the recommendation or practice of his preceptors, or by the 
dicta of the medical author in whom he may happen most to 
confide ; but it is desirable that every one should, in some meas- 
ure, be enabled to form a judgment of his own, and not surrender 
himself to an exclusive dependence, which may have a favour- 
able or unfavourable issue, as accident may determine the char- 
acter of the authority upon which the dependence is placed. 
Perhaps I may be able to supply a few hints which may be of 
some service to the student, in the exercise of a suitable degree 
of independence in his choice of medicines. 

Most of you are probably aware that, in every country or com- 
munity in which the profession of medicine is properly regulated, 
there is a standard, in a greater or less degree authoritative, 
which determines the particular medicines to be used, and the 
modes of preparing them. Such a standard is denominated a 
pharmacopoeia. The one recognized in the United States, was 
prepared under the authority of conventions, which have, at 
certain intervals, met at Washington, and may be considered as 
having represented the medical interests of the whole country. 
Our pharmacopoeia professes to give a list of all the substances, 
whether in their crude or prepared state, which are necessary to 
the practitioner of medicine in this country. As this list was 
originally prepared, after a due comparison of sentiment, by 
eminent physicians from various parts of the United States, and 



176 ON THE CHOICE OF MEDICINES. 

» 

has since, on two occasions,* undergone a most careful revisal, 
in which reference was had to prevalent medical and pharma- 
ceutical opinion and practice throughout the country, it is, to 
say the least of it, much more likely to afford a just rule for the 
guidance of the young practitioner, than the decisions of any 
single individual, however prominent. I would not wish abso- 
lutely to restrict you to the use of medicines recognized by our 
national standard. This would be to demand a subserviency, 
incompatible with that freedom of thought and action which 
is essential to any improvement of our therapeutics, and even 
to the most efficient exercise of known methods of cure. But, 
as a general rule, you will be most safe in not going beyond the 
limits of the officinal catalogue, until a judgment, matured by 
experience, shall enable you to estimate duly the character of 
newly asserted, or revived pretensions. You will assuredly 
find, in this catalogue, abundant materials wherewith to operate 
in your first practical attempts. Its copiousness, indeed, is much 
beyond the necessities of ordinary practice ; and you will by no 
means be exempt from the duty of a careful selection, even should 
your field of choice be strictly limited by its authority. 

It is advisable always to seek, in the medicines you select, an 
energy proportionate to the character of the disease ; and espe- 
cially to avoid the habit into which too many fall, of resorting to 
the most powerful on every occasion. There is a class of prac- 
titioners who seem to look upon diseases as the Stoics did upon 
sins, as all equally heinous. No sooner do they catch a glimpse 
of somethiDg suspicious in the distance, than they conclude at 
once that it is an enemy, and, without estimating his strength, 
prepare to crush him by the most energetic measures. In every 
low black schooner they discover a pirate, and direct their paixhan 

* At the present date, January, 1872, five occasions; viz., ad. 1830, 
1840, 1850, 1860, and 1870 ; though the revised copy of the last-mentioned 
year has not yet been published. — Note to the second edition. 



ON THE CHOICE OF MEDICINES. 177 

guns indiscriminately against the ship-of-thc-line and the cock- 
boat. Happily, this disposition is less prevalent than formerly, 
and, in our parts, has in great measure left the regular profession 
to seek a refuge among empirics. In the West, however, we are 
led to suppose that it still prevails with many practitioners. In 
that section of our country, they are accustomed to everything 
on a grand scale, from their magnificent streams and prairies, 
their gigantic trees and great men, intellectually as well as physi- 
cally, to their drachm doses of calomel. Perhaps the diseases, 
as they assert, may partake of the same gigantic character, and 
require corresponding treatment. Let us hope that they will 
hereafter participate in our experience, and, whether from a 
change in the character of the disease, or in the estimate of its 
force, learn, as we have done, the sufficiency, in most cases, of 
milder measures.* I would not, however, be considered as ad- 
vocating an inert treatment of disease. I am in favour neither 
of the ptisan practice of the older French physicians, nor of the 
mere moonshine of the homceopathists. All I mean is, that the 
character of the medjcine and its dose should be regulated by 
the nature of the disease ; that we should treat mild cases by 
lenient and persuasive measures, and launch our thunders only 
at the refractory and the violent. 

Another error, analogous to the preceding, is the habitual use 
of numerous medicines, without a precise knowledge of their 
powers. This is one of the characteristics of a semi-barbarous 
state of medical science ; of an age which has not yet risen out 
of empiricism. The physician expects to overcome disease by 

* I am happy to say that, in relation to the excessive use of calomel, a 
great change for the better has taken place among practitioners in the 
Western and South-western parts of our country ; though, if I have heen 
rightly informed ; the same tendency to the magnificent still occasionally 
shows itself in the use of very large doses of sulphate of quinia. 

12 



178 ON THE CHOICE OF MEDICINES. 

brute force. Out of his magazine of medicines, he hurls against 
it one after another, with little discrimination, until either the 
disease or the patient sinks. Or he mingles numerous and wholly 
discordant substances into one huge prescription, and throws it 
like a bomb into the hostile garrison, in the hope that the scat- 
tering missiles may together overwhelm the enemy, or that some 
one at least among them may do fatal execution. The latter was 
a favourite proceeding with the ancient physicians, was handed 
down by them to the middle ages, and began to decline only with 
that brighter light which broke upon the profession in the last 
century. Some of the ancient formulas which have been pre- 
served are very curious, from the number and heterogeneous 
character of the ingredients, and the utter want of any rational 
principle of association between them. Yet such is the influ- 
ence of authority and habit, that one of these mixtures, called 
the theriac of Andromachus, which has about seventy constitu- 
ents, was retained by the London pharmacopoeia of 1*746, and 
still holds a place in the French codex, with its agaric, and as- 
phaltum, and Lemnian earth, and dried vipers, and its fifty other 
absurdities. I presume, however, that its retention, in the re- 
cent revision of the French national standard, was rather a con- 
cession of the majority to the strong prejudices of the few, than 
the result of the general professional feeling. It is certainly less 
in accordance with the present intellectual illumination of Eu- 
rope and civilized America, than with the twilight condition of 
Eastern Asia, where the medical superstitions and absurdities of 
former ages flourish in a congenial soil. Dr. Parker, the medi- 
cal missionary who has acquired so much deserved credit by his 
surgical labours in China, and whom many of you may remem- 
ber as an attendant upon our lectures last winter, informed me 
that he was once applied to, by a dignitary of the Chinese Em- 
pire, for a remedy which would counteract the effects of opium 
upon the system, and, upon replying that there was no such 



ON THE CHOICE OF MEDICINES. IV 9 

remedy, was asked if he could not mix together a great number 
of medicines, some one of which might perhaps have the desired 
effect; the very idea, probabty, which led to that famous jumble 
of a multitude of incongruous substances, supposed to have been 
contrived as a counter-poison by king Mithridates, and hence 
called the milhridate. But this addiction to polypharmacy, 
though characteristic of a rude state of medicine, and certainly 
not the predominant fault of the profession at present, is never- 
theless still found with some imperfectly educated physicians, 
and with a few, who, from their peculiar position, have inherited 
the views and practices of former ages, without participating in 
the movements of the present. It is a fault, too, into which a 
young practitioner, not upon his guard, may readily fall, as it 
naturally arises from an undue confidence in medicines, derived 
from books, and not yet corrected by observation. It may be 
avoided by establishing the rule, not to prescribe a medicine, 
without a definite idea of its powers and the effects expected 
from it, and never to mingle substances in prescription, without 
having carefully considered their mutual relations, as well chem- 
ical as ph} r siological, and found them compatible in both. In 
short, the practitioner should look to the state of system, and 
the therapeutical indications which it presents, and then search, 
in his catalogue of medicines, for that one, or that combination 
of them, which is best calculated to meet these indications. 

There is a fault opposite to that just mentioned, into which, 
I think, there is at present greater danger of falling; that is, too 
limited an employment of medicines, and too great a simplicity 
in prescription. It was formerly the custom to dress up medi- 
cine in magnificent robes, and to load her with all sorts of gew- 
gaw ornaments, calculated to meet a savage or semi-barbarous 
taste. The maxim of a higher refinement, that " beauty when 
unadorned is adorned the most," appears to have recently led, 
in certain schools, to the opposite extreme of an excessive sim- 



180 ON THE CHOICE OF MEDICINES. 

plicity, which leaves the science with scarcely a garment to cover 
its nakedness. The theory of the unity of disease, originating 
with the famous Brown, and since supported, with various mod- 
ifications, by much greater names both in Europe and this coun- 
try, a theory which, in every deviation from health, recognizes 
nothing but a simple difference in the grade of action, very 
naturally led its advocates to the adoption of an amost equal 
unity in therapeutics ; remedies being employed only in refer- 
ence to their power of increasing or diminishing the depressed 
or exalted actions. Thus Brown, who saw debilitv evervwhere, 
considered himself sufficiently armed against disease when pro- 
vided with the laudanum and brandy bottles ; and Broussais, 
who could see little besides over-excitement, found in the lancet, 
leeches, and demulcents, the chief therapeutical resources of our 
art. 

The temptation to this extreme simplicity in the view and 
treatment of disease is very great : as it saves much labour of 
thought and study, and almost relieves the memory from the 
burden usually imposed upon it. Unfortunately, what it most 
wants is truth ; and, though very pretty in theory, it has been 
found not to answer in practice ; at least, after a fair trial, it has 
been generally abandoned, even where formerly in the highest 
vogue. The student will, therefore, do well to guard against its 
seductions. If induced by its plausible fallacies to neglect the 
acquisition of an ample knowledge of medicines, he will find, 
after engaging in practice, that he has yet that knowledge to ac- 
quire, and had merely postponed his labour to a less convenient 
period. 

Even when provided with a sufficient knowledge of medicines, 
the practitioner is in some danger of falling into a parsimonious 
use of them. Indolence sometimes leads us into a mere routine 
habit of prescribing. We get into the way of using some par- 
ticular medicine or combination of medicines for each particular 



ON THE CHOICE OF MEDICINES. 181 

indication, and finding them generally to answer our purposes, 
are apt not to be sufficiently careful to watch for modifications 
, of the disease, or of the constitution, habits, or tastes of the pa- 
tient, requiring corresponding changes in the medicine or the 
formula. The remark is peculiarly applicable to the country 
practitioner, who, as he is generally under the necessity of pre- 
paring his own medicines, and often of carrying them about with 
him, perhaps on horseback, finds the tendencies to curtailment, 
arising from a routine practice, powerfully seconded by his per- 
sonal convenience. 

The fact is, that a physician can hardly be furnished with a 
too copious list of medicines, provided that there is some real 
difference in their remedial properties, that, they are all in a 
greater or less degree efficacious, and that their effects have been 
so well studied that he can rationally prescribe them to meet pe- 
culiar demands of disease. It is even desirable to be in posses- 
sion of several, having a similar or identical therapeutical opera- 
tion, but differing in sensible properties, so as to render them 
acceptable to different tastes, habits, or idiosyncrasies of the 
patient. The stomach will sometimes receive a medicine when 
acceptable to the palate, which it would reject if disagreeable or 
disgusting ; and such are occasionally the squeamishness and 
whimsical changefulness of a nervous temperament in disease, 
that the practitioner is compelled to task his memory and exer- 
cise his ingenuity to the utmost, to find the means of answering 
the variable calls of the system. Under these circumstances, he 
is best off who is possessed of the greatest variety of material 
out of which to choose. 

From all that has been said, then, you will infer that while, 
on the one hand, I would avoid the untimely use of powerful 
medicines or of exaggerated doses, would reject everything not 
possessed of certain well-ascertained powers or useful properties, 
and would above all things eschew the practice of heaping to- 



182 ON THE CHOICE OP MEDICINES. 

gether discordant or ill understood materials in one empirical 
recipe, I would, on the other hand, strenuously advise the 
student to make himself acquainted with as many efficacious 
medicines, of diversified properties, as he has the opportunity to 
study, and the capacity to store away in his memory. 

In their choice of medicines, some persons are much influenced 
by reverence for what is ancient. When the world was making 
less rapid advances than at present, and at a period in reviving 
civilization when it had obviously not yet regained the standard 
of Greece and Rome, this was a very natural and an almost 
universal feeling. But now that, in almost all respects, we are 
quite on a par with the ancients, and in many vastly in advance 
of their proudest attainments, the feeling is much less common, 
and, where it exists, may be considered as almost indicative of 
eccentricity of character. Yet, to a certain extent, it does exist, 
and individuals are still to be found whose estimate of value is 
based on remoteness of origin. The rust of antiquity is in their 
eyes the philosopher's stone, which converts whatever it rests 
upon into gold. A scroll of parchment which, when written, 
would scarcely have purchased a dinner for its owner, acquires, 
by the compound interest of fifteen or eighteen centuries, a value 
exceeding that of a whole modern library. A piece of sculpture 
of some Athenian artist outweighs a modern banking-house, with 
all the paper of the bank in the same scale. To be able to trace 
his origin up to some successful robber of the dark ages, enables 
an aristocratic fopling of the old continent to outshine a Webster 
or an Irving. In the same eyes, a paring from the toe-nail of 
Galen is worth the whole brains of any score of modern doctors. 
So, a medicine consecrated by the praises of one of the old 
fathers of our art, possesses an energy not less miraculous than 
that of the decillionth of a grain of sand, which has undergone 
the due number of shakes, according to the rules of Hahnemann. 
But, as I have before said, this folly is not common, and it is 



ON THE CHOICE OF MEDICINES. 183 

scarcely necessary to put you on your guard against it. The 
tendency of our age, and more especially of our country, and 
still more especially of the youth of our country, is exactly the 
reverse. We are much fonder now-a-days of the fresh rosy 
cheek and dimpled smiles of novelty, than of the stern brow and 
gray beard of antiquity. That is the syren which is constantly 
luring us from the path of truth and sound judgment, and 
against whose deceitful charms I would now warn you. The 
subject is practically so important that it will bear, and, indeed, 
requires some amplification. 

There is a strong leaning in human nature towards what is 
new. This is peculiar to no age, country, or condition. The 
Philadelphian who joins the eager throng around a newspaper 
extra posted up before some publication office, may claim a pro- 
totype in the Athenian who sought similar information from 
those he encountered in the streets. The swarms of South Sea 
Islanders, who gathered around Captain Cook and his fellow- 
voyagers, were actuated by the same feeling as the crowd of 
Americans, who follow at the heels of a foreign lord, or greet 
with their huzzas a foreign writer of novels. But strong as is, 
and has been, and ever will be the love of novelty everywhere, 
it is a feeling which finds a peculiarly congenial soil in the 
American bosom. We are essentially a restless people. Placed 
in a new country, working our way onward by new paths, and 
governed by institutions which, if not entirely new, are greatly 
different from all that has preceded them, and withal, finding 
ourselves, upon a comparison with others, gaining upon them in 
the race of wealth and power, we have lost our respect for ex- 
perience and authority, and for everything that bears upon it 
the stamp of the past, and are accustomed to look towards the 
hitherto unknown and the untried for the means of further ad- 
vancement. Let a new scheme of physical improvement be 
proposed : we seize the idea with eagerness, and dash headlong 



184 ON THE CHOICE OF MEDICINES. 

on with it, taking the bit between our teeth, and utterly disre- 
garding the guidance and the restraints of prudence. Fulton 
proved the practicability of navigation by steam ; and, in a few 
years, there was scarcely a stream or lake in the country which 
was not covered with steamboats. A few canals had been made 
in England and France, and were the admiration of the world. 
The novelty was transplanted to America ; and the astonished 
nations, who had deemed ouv country yet a wilderness, and its 
people savages, heard that their boasted works had sunk into in- 
significance by the side of ours. Railroads and locomotives 
were started in England. A congenial chord was touched 
among us; and scarcely had the countryman ceased to be 
startled from his work by the puffing monster, with his huge 
train behind him, when the whole countrv, from one end to the 
other, and through all its recesses, appeared to be whirling along 
in every direction, as if motion were its proper element, and 
dwelling-houses but places of temporary rest. Nor are such 
results confined to mere matters of physics. Let a novelty in 
philosophy, or science, or religion, or medicine be started, and, 
true or false, we swallow it with avidity, allow it, half digested, 
to enter the vital current, and then, by the force of our thousand 
hearts, send it circulating through every portion of the system, 
either to be thrown off by our healthy energies, or to become 
incorporated in our very structure, and henceforth to form, as 
the case may be, a wholesome or noxious part of the constitution. 
You cannot look around you for a moment without being made 
sensible of this fact. It would scarcely answer to cite many 
instances. But, without going further, I may point to the ex- 
aggerations of mesmerism and phrenology in philosophy and 
science, to Mormonism in religion, and to Thompsonism and 
homoeopathy in medicine ; not to speak of that tornado of pills 
and potions which is raging at this moment, with an almost un- 
exampled fury, through the whole land. 



ON THE CHOICE OF MEDICINES. 185 

It must be clear to you that this restless love of what is new, 
while it is producing- much good, is working also no inconsider- 
able amount of evil. It is true that we have canals and rail- 
roads in abundance, thus vastly facilitating our means of com- 
munication, and the interchange of visits and commodities. But 
have we not, as a set-off, loads of debt, which are pressing us to 
the earth, an exhausted credit, a reputation suffering abroad, 
and a universal stagnation or collapse of business, following the 
excessive excitement? It is true, that we are reaping the in- 
tellectual and physical advantages of a quick reception and rapid 
circulation of moral and scientific truth, wherever it may first 
come to light. But have we not also circulated the poison with 
the nutriment? and are not our judgments weakened, our morals 
tainted, and our mental habits vitiated by familiarity with the 
outpourings of European folly and vice, not to speak of the cor- 
ruption which is generated in our own moral body, and circu- 
lated with the rest? It is true, that we have become familiar, 
in medicine, with the numerous and most valuable truths which 
the last half century has developed ; have learned to see the 
secret workings of disease within the recesses of the breast and 
heart, and have received the inestimable gifts of quinia, and mor- 
phia, and iodine. But have we not also received error along 
with truth ? Have we not felt the influence of false doctrine 
in every vein and fibre, and do we not still feel it counteracting 
the wholesome workings of the efficient and the true? And do 
we not behold every clay patient after patient, dropping out of the 
hands of regular practitioners into those of mere pretenders? 

It may be asked, are we therefore to reject all that is new ? 
Are we in all instances to decline the good, lest we receive evil 
along with it? Certainly not. But we should endeavour to con- 
trol this inordinate love, and eager search of mere novelty. In- 
stead of taking a thing to our bosom because it is new, we should 
receive it at first with suspicion, and should make its novelty a 



186 ON THE CHOICE OF MEDICINES. 

reason for a close and sifting examination of its character. When 
a stranger presents himself to us, do we receive him at once with 
open arms, introduce him into the midst of our families, give him 
access to our dearest treasures, and thus open, perhaps to fraud 
and villany, the path to their evil ends? Do we not rather ask 
for his credentials, and then afford him a fair opportunity for 
proving his worth, before bestowing upon him our whole confi- 
dence ? So should it be in our art. So should it be in our 
choice of medicines. 

At this very moment, in the rage for novelty, we are threatened 
with an innovation in chemistry,which promises to subvert some 
of the facts of the science previously thought to be among those 
best settled, and to work an almost complete revolution in its 
nomenclature. The salts are no longer to be compounds of acids 
and metallic oxides, but of certain complex radicals with the 
metals themselves. Glauber's salt has usually been thought to 
consist of sulphuric acid and soda. Henceforth, according to the 
new theory, we are to look upon it as a compound of sodium, 
and an imaginary body, consisting of sulphur and four equiva- 
lents of oxvgen. Its name of course must be changed with the 
view of its nature, and, instead of sulphate of soda, we are to 
call it, according to one chemist, sulphatoxide, and according to 
another, oxysulphion of sodium. Xow, if all this were anything 
more than mere supposition ; if the new compound radical, which 
they propose to call sulphatoxygen or oxysulphion, or any one 
of its congeners, had ever been obtained in a separate state, or 
had been positively proved to exist by a demonstrative course of 
inductive reasoning, however we might regret this rooting up of 
our deeply seated notions, and however inconvenient some of us 
rather advanced in life might find it to impose so many new and 
hard names upon our already overburdened memory, we should 
be compelled to submit, and at least to assume the appearance of 
rejoicing at the progress of science. But to be put to all this in- 



ON THE CHOICE OF MEDICINES. 187 

convenience merely for the gratification of a speculative disposi- 
tion in others; to be compelled to go back to the learning of 
words and definitions, merely that certain scientific writers may 
have the opportunity to display a peculiar skill in conjecture ; I 
submit it to you, gentlemen, if this is not rather hard ; and, when 
I tell you that, in addition to the two names for almost every salt 
which you at present learn, you will have to commit a third to 
memory, should the new notions prevail, I am sure that, fond as 
from your time of life you may be of novelty, you will agree with 
me in wishing, that this theory of mushroom growth may prove 
also to have a mushroom duration. Luckily, the strength of 
our chemical Samson is enlisted against it ; and, if it do not 
fall under his sturdy blows, it must be much more deeply rooted 
than, both for your sakes and my own, I hope it may prove 
to be.* 

Botany, another of the auxiliary sciences of materia medica, is 
subject to the same vexatious inconvenience. This, too, is made 
an arena upon which the lovers of notoriety, and the lovers of 
change, may perform their feats before the public. One can 
scarcely open a new book upon the subject, without finding new 
divisions and subdivisions of genera, translations of plants from 
their old snug site in the arrangement to another deemed more 
appropriate, and, as a necessary tail to these innovations, a long 
list of new and barbarous names to be committed to memory. 
As if this were not sufficient, each succeeding writer thinks he 
has as good a right to make a name as his predecessor, and the 
propriety of change being once admitted, proposes a designation 
of his own, and thus occasions to the learner, not only the labour 
of committing two new words to memory, but also the embar- 
rassment of a choice between them. They who have been under 

* Dr. Kobert Hare was at that time professor of chemistry in the Uni- 
versity of Pennsylvania. 



188 ON THE CHOICE OF MEDICINES. 

the necessity of studying the botanical history of cardamom, 
know, to their cost, how numerous have been the changes of 
opinion as to the character and proper designation of the plant 
producing it. After various fluctuations of sentiment, and the 
adoption successively of the generic names of Amomum, Elet- 
taria, Matonia, and Alpinia, botanists seemed at length to settle 
down upon the last, and it was hoped that the learner might 
now be left at rest. You will be sorry, however, to hear that 
the end has not yet come ; for the Edinburgh College, in the 
last edition of their pharmacopoeia, style the plant after Ros- 
coe, Renealmia, and it is highly probable that other changes are 
in store. 

But to relinquish the sportive tone, I must say to you, gentle- 
men, in sad seriousness, that I consider this disposition to change 
a great evil. Independently of the loss of time and labour in 
learning new names and new forms of things when the essence 
remains the same, we are thrown by it into a state of never- 
ceasing unsettlement, and come at length into the danger of feel- 
ing that there is nothing stable under our feet; that all which 
we have taken for truth may be nothing but false observation, 
or ingeniously devised hypothesis ; that, in fine, neither in 
physics nor morals is there any principle on which we can repose 
in undoubting and unwavering reliance. Scarcely any tone of 
feeling, whether in relation to the general interests of science, 
or to our own individual interests now and hereafter, can be 
worse than this. Without the restraint of firm principles, we 
become the sport of our fancy and passions ; and it seems to me 
that, in the course of affairs in this country, such an under- 
current may be perceived, through all the stillness upon the 
surface, setting strongly towards some great, though unknown 
catastrophe. To counteract this current should be the business 
of every well-meaning man, and every patriotic citizen ; and in 
no way, I think, can we so effectually attain this end as by deter- 



ON THE CHOICE OF MEDICINES. 189 

mining to hold fast to tried maxims and principles ; to resist 
firmly the seductions offered, both from without and in our own 
hearts, to the excitements of novelty and change ; and, when 
something new, of whatever nature, or in whatever relation, is 
offered for our adoption, to consider it most carefully in all its 
bearings, and to submit it cautiously to the test of experience, 
before heartily adopting it, and especially before allowing it to 
displace an old principle from our respect or affection. 

You will perceive the bearing of these remarks upon the sub- 
ject immediately before us. There are few things in which we 
are more apt to be led astray by the love of novelty than in the 
choice of medicines. All the most valuable and best tried instru- 
ments of our art are but too apt to fail in obstinate cases of dis- 
ease ; and, even where success is probable or certain in the end, 
it is too often slow. In our extreme anxiety and impatience, 
we are ready to catch at any aid that is confidently held out to 
us ; and, as most new medicines or preparations come recom- 
mended by a never-failing success in the hands of their intro- 
ducers, we are not without seemingly reasonable hope of advan- 
tage from them. In addition to the mere inducement of novelty, 
we have the uneasiness under a heavy responsibility, and the 
fear that we may leave some possible means untried of acquit- 
ting ourselves well in the almost fearful charge entrusted to us. 
Many yield to these influences, and make an eager trial of the 
new remedy. Perhaps accident, and those various circumstances 
which very frequently conspire to produce a false conclusion as 
to the efficacy of a particular treatment, may work in its favour ; 
and we may thus, from a partial experience, acquire a confidence 
which may lead to its further and more extensive employment, 
until the tide of fortune changes, and repeated failures at length 
conduct us back to a just estimate of its value. The continu- 
ance of the same causes leads subsequently to similar results. 
With each newly proposed remedy, we run the same round of 



190 ON THE CHOICE OF MEDICINES. 

promising trial, partial success, and ultimate disappointment; 
and the consequence sometimes is, that, drawn off from estab- 
lished methods of cure in pursuit of these ignes fatui, we find 
ourselves at last unsettled in practice and opinion, distrustful of 
the old without having acquired confidence in the new, and 
almost ready to surrender in despair all reliance upon the efficacy 
of medicine. Of newly proposed remedies, many are mere revi- 
vals of those once employed, but afterwards neglected or forgot- 
ten ; while, of the remainder, the great majority are wholly 
incapable of maintaining the place into which they have been 
temporarily elevated. Since the period at which I commenced 
the practice of medicine, iodine and its compounds are almost 
the only really new remedies which have come into general 
use ; for morphia, quinia, strychnia, creasote, etc., are merely 
the isolated active principles of medicines before well known ; 
while numerous substances, original or revived, for which 
high claims were asserted, are either altogether forgotten, or 
treated as objects rather of curiosity than real service. Let 
me, therefore, strongly urge you always, in your choice of medi- 
cines, to lean decidedly towards those of established reputation. 
Do not neglect the old tried servants of your professional fathers, 
for the crowd of younger applicants for your favour, whose only 
claims are a new face, a good deal of pretension, and a list of 
recommendations from persons you do not know. But, at the 
same time, I am far from wishing to confine you to the paths 
before trodden, and to close the access to something higher than 
we have yet attained. Well regulated efforts to widen the circle 
of the useful are highly laudable. "What I wish to impress on 
you is, that you should not adopt a medicine because it is new ; 
that you should, in fact, consider its novelty as a ground of sus- 
picion, and should admit it into your confidence, only upon 
strong and trustworthy recommendation, and after a strict 
examination into its merits. 



ON THE CHOICE OF MEDICINES. 191 

I have only one other limitation to propose to you, in your 
selection of medicines. Never, under any circumstances, employ 
those of which the composition is kept secret. Such medicines 
will be constantly urged upon your notice with the highest pre- 
tensions. The preparer will offer them to your acceptance, and 
humbly beg for a trial, either in the hope of subsequently obtain- 
ing your recommendation, or at least with the intention of making 
use of your name. Your patients, yielding to the solicitations 
of friends, or prompted by their own secret hopes, will press you 
to permit or authorize their use. But steel yourselves against 
all such solicitations, and resolve that your hand, at least, shall 
not be the one to fix a stain upon the fair fame of your profes- 
sion. You may justly ask the reasons for such a positive rejec- 
tion of remedies of asserted value. Is it not obvious that, so 
long as their nature and preparation are concealed, you can have 
no such certain knowledge of their mode of action as to justify 
you in their employment to meet any given indication ? It may 
be argued, on the opposite side, that we are equally ignorant of 
the precise composition of many other well-known remedies as 
they come from the laboratory of nature : that the secret medi- 
cine in question may have been so frequently tried, under every 
variety of circumstance, that, in relation to its physiological 
and therapeutical effects, it is as well known as those of a more 
legitimate character; and that we have no right to reject offered 
means of relief to our patient, however irregular these means 
may be. But the answer is clear ; that a substance produced by 
nature, even though its composition may not be known, can 
always be relied on as identical, if obtained under similar circum- 
stances, and treated in the same manner; while, in relation to 
the secret medicine, you can have no such confidence, as its 
mode of preparation depends on the caprice or varying views of 
an individual, not always of the best character; and, even 
though one parcel of it may have been profitably employed under 



192 ON THE CHOICE OF MEDICINES. 

certain circumstances, you can have no satisfactory proof that 
another parcel will have the same effect. But there are other 
and higher grounds for your utter rejection of such medicines. 
By allowing yourselves to be drawn into their use, you would 
give to unprincipled men the opportunity of citing your example 
as a rule for others. No matter how careful you may be, in 
employing the nostrum, to confine it within perfectly safe limits; 
no sooner will you have touched the vile thing, than the fact 
will be proclaimed wherever your name has influence, you will 
be emblazoned in advertisements, and heralded in placards as 
its indiscriminate patron, and will thus, even against your wishes, 
be made an instrument for extending its general reputation, and 
establishing it in the public confidence. After this, it will be in 
vain that you may disclaim your asserted favour. You cannot 
but acknowledge that you have used it; and all else that you 
may say will be ascribed to professional or personal jealousy, 
and will tend still further to benefit the empiric, by the oppor- 
tunity it will afford him of exhibiting himself to the public as a 
persecuted man. 

Under these circumstances, would not your first inconsiderate 
step be answerable for a proportion of all the mischief which 
may arise from the misapplication of the medicine ? Would you 
not, moreover, be lending your countenance to the general cause 
of empiricism ? Would not the whole rabble of quacks shout 
out your name as one of their supporters ? And would not 
your profession itself be in some measure degraded by this asso- 
ciation of one of its members with such a cause ? It is highly 
important, therefore, to keep yourselves strictly within the regu- 
lar limits. Exceed these, even though in a slight degree, and 
you lose all control over the result. You cannot calculate the 
evils which may flow from one false step. What is any possi- 
ble advantage which may accrue, in a single case in which you 
might be disposed to employ the nostrum, compared with all 



ON THE CHOICE OP MEDICINES. 193 

this general evil ? I do not speak thus as a mere matter of course, 
but with a strong sense of the duties of our high calling, and of 
the imperative obligation of every member of the profession to 
avoid doing anything which might degrade its character, and 
limit its sphere of usefulness. I beseech you, gentlemen, as 
you regard this character, as you value your own reputation and 
future comfort, to keep yourselves clean from every taint of em- 
piricism. Of what consequence is a little pecuniary profit ? nay, 
of what consequence are heaps of gold acquired by such impos- 
ture ? Does not a feeling of disgrace cleave to their possessor 
through his whole future life ? Does not the finger of scorn point 
to him while he lives ? and, at his death, does he not leave an in- 
heritance of shame to his descendants, so that his son and his 
son's son must blush at the mention of his occupation ? I pre- 
sume, gentlemen, there is not one among you who would not 
rather be the offspring of the humblest wood-chopper or sweeper 
of the streets, if an honest man, than of the most prosperous 
quack who ever revelled in wealth, purchased by a base course 
of deception, and at the cost of injury to thousands. You would 
shrink, of course, from leaving to those who may come after you 
a legacy, which you would look upon as a disgrace from one of 
your own predecessors. But I have been led away from the 
point to which I wished especially to direct your attention. 
There is no danger of your becoming quacks ; there may be 
some, that, unless carefully on your guard, you may afford that 
degree of countenance to quackery which is implied in the occa- 
sional employment of secret nostrums. Let me again urge upon 
you, even at the possible chance of losing a temporary advan- 
tage, to shun them altogether, and, so far as your influence may 
extend, to discourage their use by others of your professional 
brethren. 

I have now brought to a close those general observations 
which I had to lay before you in relation to your choice of 

13 



194 ON THE CHOICE OP MEDICINES. 

medicines. To sura them up in a few words ; I would advise 
that you should especially avoid the harsher remedies where the 
occasion demands only the milder, and should give none in ex- 
cessive quantities ; that, while aiming, on the one hand, at a 
rational simplicity in the succession and association of medicines, 
you should take care, on the other, not to fall into an extreme 
penuriousness in their use ; that you should exhibit an undue 
addiction neither to what is old nor what is new merely as such, 
but firmly hold on to the tried, until you can substitute some- 
thing proved to be better ; that you should never, under any 
circumstances, permit a secret nostrum to enter into your medi- 
cinal catalogue ; and, finally, that you should receive as a gen- 
eral guide the national pharmacopoeia, without, however, a 
slavish confinement within the precise limits which it indicates. 
Having thus intimated, in general terms, what you ought to 
do, and what leave undone in the selection of your therapeutical 
instruments, I have only further to recommend that you should 
make yourselves thoroughly acquainted with these instruments, 
especially in all their practical bearings. To obtain such knowl- 
edge it is, in part, that you are here assembled ; and to facilitate 
your acquisition of it is the agreeable duty which will bring me 
before you this winter. Permit me once more to welcome you 
heartily to our joint labours. 



LECTURES, 

INTRODUCTORY 

TO THE COURSE ON THE 

THEORY AND PRACTICE OF MEDICINE, 

IN THE 

UNIVERSITY OF PENNSYLVANIA. 



INTRODUCTORY LECTURES 



ON THE 



THEORY AND PRACTICE OF MEDICINE. 



Preliminary Remarks. 

The four following lectures were delivered, between the years 1850 
and 1860, as introductory to my course upon the Theory and Practice 
of Medicine in the University of Pennsylvania. Their object was to 
point out to the pupil the spirit and method in which his studies should 
be conducted, and to put him in possession of such views, as to the 
nature, extent, and objects of this department of medicine, as might 
inspire him with zeal in its pursuit, and generate in him sound prin- 
ciples to govern him in its practice. Though there is almost necessarily 
some repetition in the lectures, yet each will be found to have its own 
scope ; and, together, they constitute a system in which, I venture to 
hope, the student will find principles and motives sufficient, if allowed 
their due influence, to insure his entrance into the profession, not only 
qualified for its duties, but fitted also to dignify and adorn it by his 
demeanour and conduct. 

(197) 






LECTURE I 

DELIVERED OCTOBER 11th, 1850, 



The Theory and Practice of Medicine. 

Allow me, gentlemen, to offer you a cordial greeting, on this 
occasion of our first meeting in the new relation in which I stand 
to the medical class. Hitherto you have known me as a teacher 
of materia medica. It has pleased the authorities of this school 
to transfer me from that position to the chair of the theory and 
practice of medicine. I ask of your indulgence a few minutes of 
attention, while I refer to my own part in this change, and 
endeavour to deduce reasons, which may render your judgment 
upon my future efforts more lenient than if based solely upon 
their merits. 

You are aware that the professorship I now fill became vacant, 
soon after the close of the last session, by the resignation of Dr. 
Chapman, whose failing strength induced him to withdraw from 
its onerous duties, after a career of honour and usefulness, never 
surpassed in the medical history of this country. In the move- 
ments which afterwards took place, in reference to the filling of 
the vacancy, I was quite passive. An honourable ambition 
might suggest that the professorship of the practice, occupied 
as it had been by men so illustrious, held a somewhat more 
elevated place in public estimation than that of materia medica ; 
(198) 



THEORY AND PRACTICE OF MEDICINE. 199 

and the consideration was not without weight, that in the former 
a new field was opened, calculated to stimulate energies and in- 
dustry, which, without some fresh excitement, might perhaps 
slumber in the hebetude of increasing age. On the other hand, 
however, were the reflections, that with my existing duties I 
was quite familiar ; that to fulfil them it was only necessary to 
keep up with the advancing tide of knowledge ; that rest rather 
than increased labour was suited to my time of life, or at least 
soon would be ; and that, in making a change, I might be aban- 
doning a position to which sufficient trial had shown me to be 
in some degree adequate, for another in which I might not prove 
equally useful, or give equal satisfaction. The motives for a 
change were insufficient to outweigh those of- a contrary char- 
acter ; and having, therefore, no personal ends to answer, I had 
no other wish, in reference to the future arrangements, than that 
they might be such as would conduce to the advantage of the 
school. 

To my colleagues and to all others concerned, when inter- 
rogated on the subject, I freely made known these sentiments ; 
declaring truly that I was personally indifferent whether, in the 
approaching election, another or myself should be chosen, that 
I was desirous only that the true interests of the school should 
be consulted, and that, not being the best judge of my own 
qualifications, I should take no step in the matter, but leave it 
altogether to the wisdom of those in whose charge the institu- 
tion was placed. Should they believe that I could best serve 
the school in the department of materia medica, I would cheer- 
fully persevere in my former path of labour, and cordially greet 
any new colleague whom the trustees might elect to the vacant 
professorship. Should it, on the contrary, be thought that I 
could do better service in the practical chair, I would acquiesce 
in the decision, and exert myself, to the extent of my capacity, 
to fulfil its various and burdensome requisitions. 



200 THEORY AND PRACTICE OF MEDICINE. 

Under these circumstances, the choice, as you are aware, fell 
on myself; and I should not be doing justice to my feelings on 
the occasion, if I did not confess to you that this mark of con- 
fidence was in the highest degree gratifying to me, though in- 
volving much of labour, of sacrifice, and of misgiving on my part. 

And now, gentlemen, you will, I hope, be disposed to judge 
me leniently in my new sphere of duty, and, should the result of 
my efforts fall short of your expectations, or of the just demands 
of the position, will at least acquit me of undue presumption. 

There is another consideration, which, in justice to myself, I 
must beg of you to bear in mind, in forming your estimate of the 
ensuing course of lectures. You will necessarily compare them 
with the past. Even those of you who have not enjoyed the 
opportunity of listening to my predecessors, have yet heard, and 
still hear the prolonged echo of their praises, and have in your 
own mind formed a standard of excellence, in connection with 
this chair, by which you will naturally be disposed to judge its 
present occupant. But remember, gentlemen, that these were 
men the most eminent in their profession whom this country has 
produced, whose names are set like priceless gems in our history, 
and who, standing in the morning light of medical teaching on 
this continent, loom in magnificent hues on your admiring vision. 
Drs. Morgan, Kuhn, Rush, Barton, and Chapman, have suc- 
cessively held the professorship of the theory and practice of 
medicine in this school. Here, in this very spot, is enthroned 
the reputation of these distinguished men. A successor ap- 
proaches the place illuminated by such recollections, and is for 
the moment invested, in the imagination of the spectator, with 
the lingering effulgence. You will admit with me, gentlemen, 
that this is a most trying position. In the cold presence of 
reality, the unsubstantial glory soon fades away, and the new- 
comer stands in the severe outlines of truth, with no colouring 
from the pencil of fancy ; nay, dimmed and beclouded to eyes 



THEORY AND PRACTICE OF MEDICINE. 201 

which have been dazzled by the previous brightness. This trial 
I am now to undergo. May I not ask of you, gentlemen, to 
close your eyes firmly on the past; and, in judging of my 
efforts, if indisposed to a partial indulgence, at least to view 
them in their own true light, and not through the medium of an 
impairing contrast? 

With these preliminary observations, the personal nature of 
which may perhaps be excused in consideration of the novelty 
of my position, I will proceed at once to the proper object of this 
address ; the introduction, namely, to the notice of the class, 
of the course of instruction which it has become my duty to 
deliver. 

The subject of that course is, as you know,- the Theory and 
Practice of Medicine. Under this comprehensive title is prop- 
erly included all that relates directly to the cause, symptoms 
and signs, nature, effects, treatment, and prevention of internal 
diseases. External diseases are considered as belonging in gen- 
eral to surgery. Custom has somewhat curtailed the limits of 
the theory and practice as just defined, by separating the affec- 
tions peculiar to the female sex and to early infancy, and also 
those connected with syphilitic contamination, giving the former 
to the obstetrical teacher, and the latter to the surgeon. But, 
even with this limitation, the subject is of vast extent and im- 
portance, requiring the devotion of time, labour, and zeal for its 
mastery, and imperiously demanding such devotion, on the part 
both of those who teach and those who learn, under the highest 
sanctions of duty. 

Conscientious convictions on these points, in the outset, are 
essential to you and to myself, in our respective capacities of 
pupil and teacher. Should we enter upon our approaching duties 
with narrow views either of their extent or their obligation, what 
is to compel us into the exercise of that patient industry, that 
painful self-denial, that devotion of our whole thoughts and 



202 THEORY AND PRACTICE OP MEDICINE. 

faculties, which are essential to the right end? What is to 
guard us against the ever-present seductions of indolence and of 
pleasure ? I would imbue you, therefore, gentlemen, and I 
would most earnestly myself desire to be imbued, with a full 
sense of the vast extent of our field of labour, and of the great, 
I might almost say the awful responsibility connected with its 
cultivation. Let me endeavour, in a very few words, to set 
these points before you in somewhat of their intensity of truth. 
When I tell you that there is scarcely anything in nature, 
having relation with our bodies for good or for evil, whether 
a substance, a process, a mental act or emotion, or even the 
negation of a positve agency, which may not become a cause of 
disease ; that, in reference to the nature of disease, the most 
numerous, intricate, and subtle experiments have but opened a 
prospect here and there into its great mysteries, which have 
occupied the most profound minds for ages, and given rise to 
countless disquisitions ; that the symptoms and signs of disease 
embrace every variety of external aspect and movement ex- 
hibited by the sick, every indication offered to the ear, the touch, 
or the eye, of internal change, and every deduction of the judg- 
ment from whatever source as to the existing condition of the 
deranged system ; that the effects of disease are almost as 
numerous and diversified as the morbid state or processes to 
which the body is liable, these being very often only the results 
of antecedent morbid states or processes ; that, in the treatment 
of disease, agencies of the most varied character, including not 
only all the bodies usually called medicines, but all the influences 
capable of favourably modifying the systemic actions, are to be 
employed with variations in degree, mode of preparation, appli- 
cation, and association, as numerous as the diversities of the 
human constitution in the healthy and morbid state ; that, finally, 
in the prevention of disease, it is necessary to bring a knowledge 
of its causes, and of the influences capable of removing, neutral- 



THEORY AND PRACTICE OF MEDICINE. 203 

izing, or resisting their operation, to bear upon our decisions in 
the different cases presented ; — when all these facts are con- 
sidered, you will, I am sure, agree with me, that the subject of 
the theory and practice of medicine offers scope for all the time, 
energy, industry, and talent that you can possibly devote to it. 

But is its importance commensurate with its mass ? May it 
not be that all this vast amount of knowledge is mere useless 
lore ; the accumulation of rubbish from times past, which a more 
enlightened intelligence rejects as useless ; an Augean pile from 
the crude digestion of ages, which, instead of being laboriously 
stored in the memory of the student, rather needs the power of 
some Herculean genius to wash it away into oblivion ? The 
empirical pretender to a miraculous knowledge -and command of 
nature would probably answer this question in the affirmative ; 
the man of sense and honesty would emphatically answer, no 1 
Of the immense value of medical knowledge, if it is what it pur- 
ports to be, there can be but one opinion. To relieve pain, to 
save life, to preserve health ; these are aims, the importance of 
which can scarcely be overstated. The simplest terms in which 
they can be expressed convey at once and irresistibly to the 
judgment, the full sense of their inestimable value. No exag- 
gerations of language, no ornaments of rhetoric, can render them 
more impressive. The question, then, is, does a knowledge of 
medicine, as at present taught, really contribute toward those 
great results, which are its professed aim and end ? 

To answer this question rationally we must have recourse to 
the two great principles by which truth is tested ; to the judg- 
ment, namely, and to experience. In the first place, what is the 
conclusion of the judgment ? From the beginning of history, in 
all ages and in all civilized countries, men, among the first cer- 
tainly in mental powers and attainments, have devoted them- 
selves to the observation of disease, and to the recording of the 
facts observed. While the process of collection has thus been 



204 THEORY AND PRACTICE OF MEDICINE. 

going on, the accumulated material has been from time to time 
subjected to a careful scrutiny, aDd the false and useless, which 
must ever, while human judgment is fallible, and human pas- 
sions have their ordinary influence, mingle in greater or less 
proportion with the true, have been, in a considerable degree, 
separated, thrown aside, and forgotten. The medical knowledge 
of the present times is thus the slow growth of centuries, I 
might say of thousands of years, during which, as in the growth 
of living bodies, an intellectual digestion and nutrition have been 
going on ; the useless and effete being thrown off, at the same 
time that the useful and efficient has been assimilated ; the latter, 
however, constant!}' increasing in amount, and destined to in- 
crease hereafter, until our science shall become mature, and 
nature have yielded to human investigation all that she pos- 
sesses of the preservative and remedial. 

Now, I would ask any reasonable man, if the results of these 
ages of the industrious working of intellect is likely to have been 
in vain 1 if the best talent of all time and all countries can have 
been employed in heaping together an empty pile of nothingness, 
to be puffed away by the breath of ignorant enthusiasm, or char 
latan pretension ? Is it possible that the two hundred thousand 
physicians, who now have under their charge the health of the 
civilized world, men of the best education and highest intellect, 
many of whom are the glory of the country, and the ornament of 
the age in which they live, should be so far mistaken as to yield 
their undoubting confidence to a huge mass of error ; that they 
should have devoted their lives to the prosecution of vain 
shadows ; or that they should recklessly sport with the lives 
of others, under a false pretence of knowledge ? 

It may be said that medicine, like certain false religions, is a 
great system of fraud, got up by the self-interest of shrewd but 
unprincipled men, believed in by the multitude of uninitiated dis- 
ciples, and used by the few wiser heads intrusted with its mys- 



THEORY AND PRACTICE OP MEDICINE. 205 

teries, for the purposes of their own lust of wealth or power. 
But only stupidity or malignity could bring such a charge 
against it. Where are the mysteries of our profession ? Are 
not the magazines of knowledge open to all who choose to 
enter ? Instead of concealment or mystification, are there not 
interpreters ever ready to make clear and easy whatever may 
seem obscure or difficult, so far at least as discovery has yet 
advanced ? Do we profess to have secret depths which ordi- 
nary intellect cannot fathom ? Do we claim certainty or uni- 
versality of knowledge, or infallibility of judgment ? Or, rather, 
do we not profess openly that our science is yet imperfect; that, 
though much has been learned, yet much still remains to be 
learned ; that, though we can do much good, we cannot do all 
good ? Do we not proclaim that we seek only for truth ; that 
we are open to its reception from whatever source it may come ; 
and that our greatest zeal is to enlarge the boundaries of our 
knowledge, and the extent of our capacity of usefulness? 

Ours is no special theory originating in the excitement of an 
insane imagination, the suggestions of an extravagant vanity, or 
the promptings of interested ambition or covetousness. It is the 
interest, and has been the trickery of charlatanism in all its 
branches, to represent the genuine practice of medicine as a 
peculiar system, old, worn out, effete, good perhaps in its day, 
but in all respects inferior to the new system of some inspired 
founder, some new medical dispensation, which is to supersede 
all former modes of practice, and to continue unimpaired until 
the latest time. You know, gentlemen, that we acknowledge 
no special system. Imaginative minds in our profession have 
from time to time put forth hypotheses; many of them, it is 
true, futile ; many with but partial glimpses into yet undis- 
covered truths : but these are received for what they are worth, 
examined, sifted, and partially or wholly rejected, as they prove 
to be more or less founded in truth, or altogether baseless. It 



206 THEORY AND PRACTICE OP MEDICINE. 

has been the war cry of homoeopathy to call us allopathists ; and 
some physicians have been weak enough to recognize the name. 
But we are not allopathists. We proclaim entire freedom from 
the bonds of all narrowing hypothesis. We are, as I have 
already asserted, honest seekers after truth, willing to take it 
wherever it can be found ; to pick it up even from the kennel or 
the common sewer of quackery, if it happen to be seen sparkling 
amidst the filth. 

Our profession, therefore, is not a pretence. We are all firm 
and honest believers in it. Is not this obvious to the most cur- 
sory inspection, if but impartial ? Look abroad among the prac- 
titioners of medicine. Do you not find many of them among the 
most respected and honoured ; joining in all liberal and benevo- 
lent schemes to the extent of their means ; living consistently 
with their profession ; subjecting their dearest friends, their own 
families, themselves, to the same treatment which they apply 
to their patients generally ? And then, inquire into their secret 
walks. Where are they but among the poor and wretched ? 
How many instances are of daily occurrence in which wants are 
relieved, suffering alleviated, and life saved, by their unpaid and 
even unknown ministrations ! No, gentlemen, we are not de- 
ceivers. We are, as a body, not likely to be deceived. If these 
are facts, then is there reality and truth in medicine. 

What has been hitherto said refers rather to authority and 
opinion than to positive proof. I have asked your belief in our 
science from your confidence in those who have preceded you. 
I have appealed to your judgment, upon the basis of faith in the 
existence of common sense, honour, and virtue among men. But 
the evidence of experience may also be adduced. 

To the practitioner himself the proofs of the efficacy of his mea- 
sures are too frequently offered to admit of doubt. Every day 
he witnesses cases of suffering, in which relief follows almost 
immediately the use of appropriate remedies. Chronic affections 



THEORY AND PRACTICE OP MEDICINE. 207 

frequently come under his notice, which, after a long course of 
steady deterioration, with no hope of spontaneous amendment, 
commence a course of amelioration from the moment that the 
influence of treatment is felt ; and it often happens that the 
period at which benefit will accrue may be confidently predicted. 
It is his great happiness to believe that, in not a few instances, 
fatal results are averted through his instrumentality. 

It is true that most diseases, if left to themselves, and some- 
times even under positively injurious treatment, will sooner or 
later terminate favourably, through the inherent powers of the 
system. Hence the frequent apparent success of irregular and 
unskilful practitioners. It is in fact on this basis, and on the 
prevalent ignorance of the truth just stated, that the whole edi- 
fice of quackery, in all its forms, mainly rests. The spontaneous 
curability of most diseases is to the medical charlatan, what the 
regular and calculable, but generally unlooked for recurrence of 
certain natural phenomena is to the juggler and mountebank. 
A traveller from civilized life, thrown among savages, predicts 
an eclipse of the sun or moon as the result of his own command 
over nature, and gains credit for what he claims by the fulfilment 
of his prediction. The empiric knows that a disease will in all 
probability end favourably within a certain time, and, adminis- 
tering his nostrum, claims the result as a proof of his own skill. 
Sometimes, no doubt, he is himself deceived, and has a real 
faith in the efficacy of the means employed. But, even in these 
spontaneously curable cases, where, as a general rule, the igno- 
rant practitioner does nothing, or does only harm, the well-in- 
structed physician often finds that he can lessen the degree, and 
shorten the period of suffering. He too often witnesses the mis- 
erable leavings of quackery, the sufferings unnecessarily severe, 
the disease unnecessarily protracted through the want of proper 
and efficient means, to be able to hesitate in his own opinions. 
But this experience of his own cannot be made also the experi- 



208 THEORY AND PRACTICE OF MEDICINE. 

ence of others ; the quack claims equal credence for his asser- 
tions ; and unfortunately the gullible public have no other means 
to judge between them than the too often wanting quality of 
common sense. Our individual testimony might not, therefore, 
be received, and it is necessary to have recourse to results which 
are obvious to multitudes. 

For yourselves, my young friends, nothing more would be 
wanting to conviction than a close attendance, for a single season, 
upon the wards of our hospitals. You there have the opportu- 
nity of seeing patients, who had been gradually becoming worse 
and worse for weeks or months, or who, it may be, had been 
suffering for years, beginning to improve under the means em- 
ployed, and regularly going on to health, often at the very time, 
and in the very manner predicted by the prescriber. The blood- 
less young woman, with her palpitating heart, her embarrassed 
breathing, and nervous symptoms of extreme violence, is put on 
the use of the preparations of iron, and, in from three to six 
weeks, leaves the hospital, rosy, cheerful, and in full health. 
The bloated, dropsical patient, whose disease had been slowly 
advancing for months, takes his fox-glove, or cream of tartar, or 
some other equivalent remedy, and rapidly recovers under its 
influence. Every variety of chronic inflammation you behold 
yielding to the careful administration of mercury. Skin diseases, 
which have been the misery of their victim for years, perhaps 
rendering life itself burdensome, vanish before your eyes under 
the use of arsenical preparations. 1 might go on multiplying 
such cases, and might confidently appeal, for the accuracy of 
my statements, to those of you who have enjoyed the requisite 
opportunities. 

But evidence still more general is not wanting. Every one 
knows that intermittent fever and scurvy, which were of old 
most formidable and destructive diseases, are completely under 
the control of remedies ; and that cholera, so tremendously fatal 



THEORY AND PRACTICE OP MEDICINE. 209 

if neglected, may almost always be cured if subjected to proper 
treatment in its earliest stage. The records of history are full 
of the devastations of small-pox, which has now been stripped 
of its terrors through the instrumentality of the physician ; and 
a scourge of the vicious, at one period scarcely less fatal than 
that terrible disease, acknowledges in almost every instance the 
efficacy of medicine. 

The grand truth, however, that speaks more strongly than 
any other to the public ear, is the well-known fact, that the rate 
of mortality has greatly diminished, and the general duration of 
human life greatly increased, within the period of time that has 
witnessed the most rapid advance of medical science. Some- 
thing of this, it is true, may be due to the general progress of 
civilization, to the wide diffusion of the comforts of life among 
the poorer classes, to the better knowledge of the principles of 
hygiene, and the consequent removal or correction of many of 
those causes of disease which were once so prevalent ; to clean- 
liness, for example, in living, to an improved diet, to better ven- 
tilation, and to the prevention of morbific effluvia, whether from 
crowded human beings or from paludal sources. But these ame- 
liorations are in great measure owing to the influence of en- 
lightened medical opinion ; and, even setting the results of this 
aside, enough remains of the direct effect of our art, in the more 
certain cure and prevention of disease, to give it, in every im- 
partial mind, the credit of great efficiency. 

With these truths, then, young gentlemen, before you — that 
the theory and practice of medicine embraces a vast amount of 
knowledge, and that this knowledge is available for the most 
important practical purposes — you will confess yourselves bound, 
by every principle that can influence a rational and responsi- 
ble being, to use your utmost endeavours to qualify yourselves 
for its proper application ; and will not fail to co-operate with 
me, during the coming session, in earnest efforts for this end. 

14 



210 THEORY AND PRACTICE OP MEDICINE. 

But I would not have jou to be discouraged by the amount 
of various knowledge that claims your attention. It is not to 
deter, but to stimulate and inspirit you, that I have portrayed 
in somewhat vivid colours the difficulties before you. More is 
not required of us than we can perform by a reasonable exertion 
of our faculties, and a fair use of our opportunities. Impossi- 
bilities, or results attainable only by the sacrifice of comfort and 
health, are required of no man. Besides, our attainments are 
often necessarily limited by circumstances quite beyond our con- 
trol. In this country the habits of business permit only the de- 
votion of a certain limited time, as a general rule, to preparation 
for active life. Our whole system of education is based on this 
fact. This is true of medicine, as of every other branch of pro- 
fessional knowledge. A certain period is fixed for study ; not so 
long as our best interests would demand, but as long, it is 
thought, as can be spared from practical pursuits. If, during 
this period, you devote a faithful attention to the acquisition of 
knowledge and skill, you will be justified to your consciences, 
though still more or less deficient. No man is in this respect 
perfect. All have deficiencies ; and, through life, no matter how 
long it may last, our constant endeavour should be directed to 
their correction. You will learn, before many years, that your 
graduation in medicine is simply the era, at which you are to 
begin your own self-guidance in the pursuit of professional 
knowledge, and by no means the evidence of your having at- 
tained sufficient knowledge already. Be not alarmed, then, by 
the apparent difficulties of your path. Let not the fear of being 
unable to acquit yourselves creditably, discourage you from 
availing yourselves of the best advantages in your power. We 
do not ask of you what you cannot well perform, what cannot 
be readily accomplished by ordinary abilities and a willing 
spirit, in the time allotted for preparation. 

In order that the young men attending our school may have 



THEORY AND PRACTICE OF MEDICINE. 211 

the largest practicable opportunities for learning, we have length- 
ened that portion of the period of study, during which you have 
the aid of a regular system of teaching. In other words, the 
courses of lectures in this school have been gradually prolonged 
of late years ; and, instead of being confined to four months as 
originally, are now extended to six. This was, in fact, nothing 
more than was necessary to keep us from retrograding from that 
position, which, as a school, it has been our ambition to main- 
tain. The science of medicine has been greatly enlarged within 
the last fifty years ; and to teach it as thoroughly as it was 
taught before that period requires a longer time. If four months 
were but sufficient then, six months are certainly requisite now. 
It is vain to say that the former period is amply sufficient ; that, 
by crowding much upon the student, he is compelled to exert 
himself more ; and that he will learn as much in the shorter as 
the longer term. The judgment refuses to listen to such puerile 
sophistry. You might, on the same principle, lessen the period 
to three months, two months, or even a single month ; and at 
last it would be reduced to a vanishing quantity, equivalent to 
the homoeopathic dose, and just about as effectual. There would 
be some consistency in such diminution by the disciples of 
Hahnemann ; but it would not do for those who profess to be 
guided by reason and common sense. 

It may be said that the six months' system, though required 
by the interests of the profession, is unsuited to the condition of 
the country. Whether this is so or not can be ascertained only 
by trial. So far as the experience of this school has hitherto 
gone, it has been in favour of the extension of the term. We 
have never been so prosperous as on the average of the last few 
years.* 

* Though this statement was true at the time it was made, yet it soon 
became obvious, after the first enthusiasm of the profession, under the 



212 THEORY AND PRACTICE OF MEDICINE. 

That it is beneficial to the student, we have not only the infer- 
ence of the judgment, but the positive results of our own observa- 
tion. Assuredly, our classes of graduates have never been so 
competent as since the extension of the courses. 

There is some honour, too, gentlemen, in graduating where 
the requisitions are high. I have never heard one of our alumni 
say that he repented having attended during the prolonged 
session. 

But I would repeat again, that, while we are unwilling to 
prostitute the honours of this school to wilful ignorance and 
notorious incompetence, we have no wish to be severe with the 
pupil ; but, on the contrary, feel a parental interest in his success, 
and expect nothing from him which is in any degree beyond his 
power. You will, therefore, so far from being discouraged by 
the picture presented to you, but feel yourselves inspired with 
greater zeal and energy, and will enter on your winter's course, 
determined to exert yourselves faithfully, not for your own good 
only, but for the honour of the school of your choice, and, may 
I not add, for that of your teachers also. 

It will be proper for me, before closing this address, to make 
you acquainted with the outlines of the plan upon which the 
ensuing course of lectures is to be conducted. 

The main objects will be to present to the student the promi- 
nent and most important points of the subjects to be treated of, 
to render these perfectly clear to his understanding, and to 
impress them as forcibly as possible upon his memory by suit- 
influence which gave rise to the American Medical Association, had sub- 
sided, that our school would be unable to sustain itself in the degree of 
expansion which it first attempted, and that the six months' course must 
be abandoned. In contracting the course, however, the University 
retained five months of instruction, and has continued to do so to the 
present time. This period exceeds the old length of session by about one 
month. 



THEORY AND PRACTICE OP MEDICINE. 213 

able illustrations whenever practicable. My wish is to go over 
the whole ground of the theory and practice during the session. 
This is a vast region, with subdivisions having innumerable 
diversities of boundary and of surface, and presenting objects of 
more or less utility at almost every step. To survey the whole 
minutely, in one session, is obviously quite impracticable. No 
human power would be adequate to the task of description in 
the space of time allotted ; and, even were the task possible, no 
human intellect would be capacious and retentive enough to 
receive and hold all the objects presented. There is, then, but 
one alternative. Either the lecturer must content himself with 
going over the ground in a more or less general manner ; or, if 
he wish to consider the subject in detail, and thus completely to 
exhaust it, he must take it up in sections, and treat of these sev- 
erally in different sessions. 

The latter method is objectionable on more than one account. 
It destroys all unity of instruction. The student receives infor- 
mation in parcels, at distant periods, and is thus in some degree 
disabled from forming those general conceptions applicable to the 
whole subject, which are of great use in giving consistency, and 
the most efficient practical applicability to his knowledge. In 
the intervals he is apt to forget much that he had learned, and 
cannot, therefore, upon resuming his attendance, justly appre- 
ciate the bearings of the past upon the present instruction, nor 
enjoy fully those advantages, which, in the ascent to knowledge, 
are always gained by mounting regularly and continuously, 
making each step the means of gaining the one immediately 
above it. 

But a more serious objection. arises from the regulation of our 
school, which permits students who have attended one full course 
elsewhere to graduate after a single course with us. Many young 
men avail themselves of this regulation, and for these the instruc- 
tion would be but half, or perhaps less than half completed. Com- 



214 THEORY AND PRACTICE OF MEDICINE. 

ing hither with the expectation of being fully taught, they would 
leave us with their education unfinished, and of course, so far as 
this chair is concerned, but half prepared for the fearful encoun- 
ter with disease to follow. 

In order that justice may be done equally to all who favour 
us with their attendance, it is necessary that the whole circle of 
instruction should be completed in a single session. This can be 
accomplished only by adopting the former of the two plans re- 
ferred to ; that, namely, which selects the most characteristic and 
most important points of each subject, and places them with due 
prominence before the learner, referring him for minute details 
to published treatises and private study. This is the plan, as 
you are aware, which I propose to follow. It is, I believe, in 
itself the most appropriate for oral teaching, even if the period 
allowed for instruction were much longer than it is. Were the 
lecturer to attempt an elaborate picture of every disease in all 
its relations, he would necessarily introduce numerous details 
of little importance, which would fatigue the attention and mem- 
ory, and, like the prospect from the window of a railroad car, 
would leave but imperfect and shadowy impressions in the mind. 
His object should, on the contrary, be, to strike off accurate and 
vivid sketches, like those made by the painter with a few touches 
of his pencil, which often convey to the observer a stronger im- 
pression of the real than much more elaborate pictures. 

Along with the prominent and peculiar features of the several 
diseases, in all their different relations, I propose to give you 
the results of my own personal observation, reflection, and ex- 
perience, so as to render the course in some degree characteristic. 
Another object will be to make the lectures as demonstrative as 
possible by introducing illustrative representations, such as 
morbid preparations, drawings, models, etc. ; in this way appeal- 
ing to the eye as well as the ear, and seeking an entrance into 
the understanding and memory by two avenues instead of one. 



THEORY AND PRACTICE OF MEDICINE. 215 

To enable me to fulfil this latter purpose, I made during the 
summer, as many of you know, a voyage to Europe ; and I am 
happy to inform the class that it has not been altogether fruit- 
less. I have already received a considerable amount of illustra- 
tive material ; and, unless the winds and waves thwart my ex- 
pectations, shall receive more in time for use this winter ; but, 
as much that I ordered requires time for its preparation, I fear 
that all the results of the voyage may not be available during 
the present session. 

It seems to me that, before entering regularly on the duties of 
this place, it may not be unbecoming to pay my small tribute to 
the merits of him who filled it before me.* Happily, though with- 
drawn from an active participation in our labours, he is still 
among us, and, in the office of Emeritus Professor of the Theory 
and Practice of Medicine, yet lends his countenance to the 
school, which he so long aided to support and elevate by his 
prelections. It would be grateful to me, could I, with a due re- 
gard to propriety, delineate to you those personal traits of our 
honoured friend, the expanded intellect, the fine imagination, the 
extraordinary judgment, the keen insight into character, the 
ready and cheerful wit, and, above all, the kindly feelings and 
excellent heart, by which he has ever been distinguished among 
those who have known him best. I should delight in doing jus- 
tice to the quick flow of thought, the rapid combination, the ready 
perception of ludicrous analogies, and the copiousness of lan- 
guage, which rendered him one of the best extemporaneous speak- 
ers, and caused all that he said, whether in ordinary converse, at 
the festive board, or on more stately occasions, at once to impress 
with its justness of thought, and to delight by its sparkling 
pleasantry and imaginative brilliancy. It would be a source to 
me of unmingled satisfaction, could I follow him in the daily 

* The late Dr. Nathaniel Chapman. 



216 THEORY AND PRACTICE OF MEDICINE. 

walks of life, into the private circle, the sick chamber, the meet- 
ing of business or of pleasure, and endeavour to represent to you 
those qualities, which, wherever he went, caused his coming to 
be hailed with pleasure, and gave a charm to his intercourse, 
which it is the happiness of few to command in this world of 
struggle and of strife. But respect for the decencies of life for- 
bids such an analysis of living character, even where nothing 
bat what is creditable would be displayed ; and I must content 
myself with referring to facts and incidents, which, being more 
or less of a public nature, are a fair subject for contemporary 
notice. 

Thirty-five years ago, when I first entered as a student into 
the medical department of this University, Dr. Chapman was 
professor of materia medica, to which chair he had been elected 
in 1313. I recollect that, even then, though a young man, he 
was among the most popular teachers of the school. In 1816, 
he was made professor of the practice ; and for two winters I 
had the pleasure of listening to his instructions. It was from 
him undoubtedly that I received many of those therapeutical 
views, which I have ever since held, and which will be incul- 
cated in the ensuing lectures. I need not tell you that he con- 
tinued to hold that professorship until his resignation last spring, 
a period of about thirty-four years. 

In the prime of his life, he attracted about him large classes 
of private pupils, for the instruction of whom he associated with 
himself several vounsr men, who afterwards formed with him 
the Medical Institute, and most of whom have since attained 
eminence in their several departments. Professors Horner, 
Jackson, and Hodge of the University, and Professor Mitchell 
of the Jefferson School, were among his associates. Xo medical 
man upon this continent, probably no one in the whole world, 
has been concerned in the education of so many pupils public 
and private ; and thousands scattered over all parts of the United 



THEORY AND PRACTICE OF MEDICINE. 2 It 

States, many of them the most distinguished men of their re- 
spective neighbourhoods, hold his name in honoured and affec- 
tionate remembrance. Though not the oldest in years of our 
medical men, he certainly deserves to be considered, more than 
any other living individual, the patriarch of his profession in 
this country. The general feeling of that profession towards 
him was flatteringly evinced in the year 1847, when he was 
chosen by the great American Medical Association, then meeting 
in this city, their first President ; and they who were present on 
the occasion vividly remember the feelings of affectionate enthu 
siasm, with which his installation into that highly honourable 
office was greeted. 

As a practising physician, he has been scarcely less eminent 
than as a teacher. In this city, he has always been among 
those who enjoyed the highest confidence of the community; 
and, throughout the Union, his reputation as a practitioner was 
such that his opinion was eagerly sought, and many came hither 
from great distances for the benefit solely of his advice. The 
younger members of the profession looked up to him with affec- 
tionate confidence, loving his warm, genial nature, as much as 
they respected his abilities ; and his aid in consultation was 
habitually called in by the most distinguished among us, long 
after his advancing age had induced him to withdraw, in great 
measure, from the more active offices of his profession. 

Nor was it only in the ranks of his professional brethren, or 
among those bound to him by the strong tie of medical service, 
that he was highly esteemed. The position long held by him of 
Yice-president of the American Philosophical Society — the most 
distinguished scientific body of the continent — and that of Presi- 
dent of the same society to which he was afterward elevated, 
evince the respect entertained by the best informed men in the 
community for his general intellectual endowments. 

His career throughout, from youth to manhood, from manhood 



213 THEORY AXD PRACTICE OF MEDICINE. 

to old age. has been in the greatest degree prosperous and flat- 
tering ; if the most kindly regards, general respect, a wide social 
and professional influence, a reputation limited only by the 
bounds of civilization, and the highest positions not political 
which an individual can attain in this country, may be con- 
sidered as evincive of prosperity and honour. 

Feeling the weakness of age encroaching upon him. he has 
spontaneously withdrawn from all his active duties, and all his 
elevated positions : and now, reposing on his yet unfaded laurels. 
amidst the grateful ministrations of affectionate kindred and 
friends, he may look back to the crowded scenes of the past, and 
forward to the vast uncertainty of the future, with the calm 
feelings of one who has done his work in the day. and may hope 
for a peaceful reward, when the sun of a new and endless morn- 
ing shall rise after the night of life. 

Our school, deprived by Dr. Chapman's advanced age of one 
of her main supports in times past, is now about entering on a 
new stage of her long existence. Two of the professorships have 
undergone a change of occupants. What is to be the effect upon 
her fortunes time alone can determine. In relation to the chair 
of materia medica. which became vacant by my own transfer, I 
have no misgivings. The thorough familiarity of our new col- 
league with the subject to be taught, his long and satisfactory 
service as a lecturer upon that subject in a school which has 
been a nursery of teachers, and the zealous energy with which 
he enters upon the duties of his present office, assure us that the 
department of materia medica will not suffer by the change.* 
How it may be with that of the practice, it is not for me even to 
conjecture. I can only assure you that my very utmost shall be 
done, in every way, to satisfy the friends of the school; and, 

* Dr. Joseph Carson, the present professor of materia medica in the 
school. 



THEORY AND PRACTICE OP MEDICINE. 219 

should there be a failure, it shall arise from want of capacity, 
and not from any deficiency of zeal, effort, or devotion. 

As an institution, I can say proudly, apart from any personal 
concern, that we deserve success. It has been, and continues to 
be our great aim, to maintain medical education at the highest 
point of which it is susceptible among us, and thus to contribute 
at once to the elevation of the character of our beloved profes- 
sion, and to one of the greatest temporal interests of our no less 
beloved country. In that profession, and in that country, I have 
an abiding confidence that they will not forsake us, so long as we 
continue to merit their support ; and you yourselves, my young 
friends, as future members of the same profession, to share in 
its prosperity or decay, will sympathize with jis in our ardent 
wishes, and do what you can to contribute to the same great, I 
had almost said, holy end. 



LECTURE II. 



DELIVERED OCTOBER 10th, 1851. 



Requisites in the Study of Medicine. 

Accept, gentlemen, my cordial greeting. We have met to- 
gether with a common purpose ; to enter, namely, upon a course 
of duty. My part is to teach you the theory and practice of 
medicine ; and I do not know that I can better begin the per- 
formance of the duty than by giving some general precepts to 
guide you in the study. 

1. The first and most important requisite, without which all 
effort must be languid, all appliances partial in effect, and the re- 
sult, to say the least, unsatisfactory, is the possession of a proper 
spirit on the part of the student. If he approach his task cold 
and careless, merely as something he has undertaken and must 
finish, without any just appreciation of its nature and objects, he 
will assuredly fall far short of the attainments, essential to the 
character of an accomplished physician. 

But to become imbued with this spirit, he must have a deep 
sense of the importance of the study in which he is about to en- 
gage, of its great ends, of its fitness for those ends, and of its 
claims upon his conscience as a responsible being. These are 
points, therefore, which I wish to impress on your attention. 

When I tell you that the object of the theory and practice of 
(220) 



REQUISITES IN THE STUDY OF MEDICINE. 221 

medicine, as a department of medical science, is to qualify di- 
rectly for the cure and prevention of disease, in other words, for 
the relief of physical suffering and the preservation of life, I say 
all that is necessary in relation to its ends. Except the salva- 
tion of the soul, nothing can be more important. But is it really 
adapted to the attainment of these ends ? Is it in fact what it 
claims to be ? There are many who profess to doubt, many who 
absolutely deny its usefulness. But who are these unbelievers? 
Are they men of information, reflection, and sound judgment, men 
too who have had the opportunities for correct decision ? If so, 
their opinions must have weight. Let us examine this question. 

They who, by diligent study and long experience, have made 
themselves familiar with the practice of medicine in its princi- 
ples and application, are certainly best fitted to judge correctly 
on the point referred to. Do we find these denying and decry- 
ing the importance of the study ? Certainly there are many 
honest and honourable men among them. Do these acknowledge 
their error, and abandon their profession as a system of fraud 
and deception ? On the contrary, do they not in practice and 
precept maintain the validity of its claims ? Do they not devote 
their whole energies, their time, their life, to the performance of 
its duties, often even when mere worldly interest would lead 
them into other paths ? 

There are undoubtedly medical men who have renounced, and 
now abuse their profession. But who are they ? Some may 
be sincere ; men of unstable minds, whose fancy predominates 
over their judgment, eccentric in their habits of thought, border- 
ing in fact upon insanity, if they may not be deemed actually 
insane. But by far the greater proportion are mere calculators, 
whose views of honour and honesty are measured by a pecuniary 
standard, to whom human life, at least the life of others, is of 
little value compared with money, and who, not succeeding to 
their satisfaction as regular physicians, and deterred by the fear 



222 REQUISITES IN THE STUDY OP MEDICINE. 

of the penitentiary or the halter from illegal crimes, have taken 
up the trade in human life and happiness in the safe form of 
quackery. Assuredly, these are not the men from whom you, 
my young friends, would be disposed to adopt your medical 
faith. 

As to the opinions of those who have never studied medicine, 
their value is much affected by the consideration that they are 
based in ignorance of the subject. Their sources, too, when 
carefully examined, will for the most part be found such as com- 
pletely to neutralize their force. 

One of these sources is a feeling of envy or jealousy, which 
cannot tolerate the superiority of medical men in intelligence 
and general esteem, and delights in every opportunity of dero- 
gating from the profession. 

Another is an ignorant pride of opinion, which glories in an 
asserted independence of all established belief, and is usually ob- 
stinate in proportion as it is erroneous. 

A third is a vain love of notoriety, which enlists under every 
flaunting banner of novelty, if it may only be allowed to act, or 
to suppose that it is acting a conspicuous part. Who does not 
see that this is a ring in the nose, by which many a quack leads 
his throng of male and female advocates ? 

A fourth source, and probably one of the most frequent, is a 
certain restlessness of character, or flightiness of imagination, 
which is ever ready to seize on any new plausibility, and ex- 
hibits adhesiveness only when strongly committed with the pub- 
lic, or with some limited circle. 

But undoubtedly the most frequent source is an honest but 
weak credulity, which yields belief from its own sincerity of 
nature ; a principle of which quacks, swindlers, and impostors 
of all kinds have always taken advantage, and will ever con- 
tinue to do so, as long as imbecility and ignorance shall exist. 

I need not refer, in addition, to the source of unscrupulous 



REQUISITES IN THE STUDY OP MEDICINE. 223 

self-interest, which oversteps all obstacles in the pursuit of its 
ends, sweeps aside from its path honour, and honesty, and truth, 
and self-respect, and the respect of the world, and wades through 
groans, tears, and death, to the sordid object of its desires. We 
shudder at the horrors which have attended the track of the rob- 
ber and the pirate ; of a Pizarro to his gold, of a Robespierre to 
his power ; but in what are they worse than the medical pre- 
tenders, who, without knowledge, or against better knowledge, 
put life and all its attendant blessings at constant hazard ? nay, 
are they not even more respectable, as they venture life against 
life, while the charlatan risks nothing of his own except char- 
acter in this world, and happiness in the next, both of which he 
has taught himself not to value ? 

Such, then, are the influences which combine to underrate and 
decry the value of regular medical practice. Are they such as 
ought to have weight in your estimation ? Can they stand for a 
moment against the testimony of the great body of educated and 
honest physicians; against the practical evidence borne by the 
mass of civilized men in confiding their lives to our skill ; in fine, 
against the clearest dictates of common sense, which would cer- 
tainly ascribe more efficacy to the combined medical experience, 
and the aggregate medical reason of all ages, which true medical 
science is, than to the crude theories of a single man, to the wild 
ravings of an insane fancy, or to the mere unsupported preten- 
sions and assertions of the pure charlatan ? Indeed, so power- 
ful in this respect is the influence of the common sense of man- 
kind, that, even with the most bitter opponents of our science, it 
often happens that, in the last fearful crisis, when the passions 
of this world are silent before the threatening presence of death, 
the aid of the regular physician is invoked as the only remaining 
hope. How often are we called to the death-bed of the wretched 
victim of delusion, to mourn over opportunities irretrievably 
lost ! to witness the last expiring glimmer of a life that might 



224 REQUISITES IN THE STUDY OF MEDICINE. 

perhaps have been rescued, but for baseless doubts of regular 
medicine on the one hand, and equally baseless confidence in 
some miserable quackery on the other ! 

You can have no doubt, then, of the inestimable value of this 
branch of medicine. You feel deeply that it is worthy of what- 
ever effort or sacrifice may be requisite to make you masters of 
it. But this is not all. The nature of its practical duties is 
such, that a neglect of the means necessary to fit us for their 
performance is a great moral wrong. The artisan, the farmer, 
the merchant, the lawyer may be badly qualified for his duties, 
without other evil than his own failure, or some temporal incon- 
venience to those who trust him. A similar deficiency on the 
part of the physician may and frequently must occasion the loss 
of life, and thus fix the everlasting position of the patient. Error 
with him is often irretrievable ; and its consequences may be felt 
through time, and through eternity. Upon your consciences, 
therefore, is the duty of proper preparation obligatory. These 
considerations should generate in you a spirit of zealous devo- 
tion to your studies now, and to your profession hereafter ; a 
spirit above all sordid views, which shall look for its reward not 
merely to the acquisition of money or fame, but to the noble con- 
sciousness of powers fitly exercised, to the sweet comfort of an 
approving conscience, and, above all, to the smiles of the all- 
knowing and all-powerful, in whose will are our destinies forever. 

2. The next great requisite is due preliminary preparation. It 
would be easy to fill this lecture with proofs of the importance of 
a preparatory education to the medical student, and with details 
of its desirable quality and extent. But such lessons are now out 
of place. You have already entered into the study of medicine. 
Whether duly or unduly prepared, you have already commenced 
the journey ; and it would be useless to recur to the past. I would, 
however, urge on those of you who may be sensible of any defi- 
ciencies in this respect, to give a portion of your leisure to the 



REQUISITES IN THE STUDY OF MEDICINE. 225 

means necessary to supply them. Especially would I recom- 
mend the study of the elements of natural philosophy, and of the 
grammatical structure of the Latin language, the former as 
essential to correct physiological knowledge, the latter to a due 
appreciation of medical nomenclature. To the commencing 
student not already familiar with these subjects, the devotion to 
them for a few months of the intervals of professional study, 
too often spent in mere amusement, will be of infinite service in 
facilitating his subsequent progress. 

There is one point connected with this branch of our subject 
to which I would invite your special attention^ I refer to the 
importance of a proper habit of study. This is one of the great 
advantages of an early education. A well-instructed young man 
comes to the study of medicine with a certain mental training 
and discipline, as important in the conquest of its difficulties as 
military training is to the soldier. To those, however, without 
this advantage, yet possessing a teachable spirit, a word of 
counsel may be of great value. Do not confound together read- 
ing and study. Do not suppose that, simply because you have 
read a book through, you know anything of its subject. 

I recollect well, in my student days, a young man in the same 
office with myself, who used to shame us all by his extraordi- 
nary diligence. He was incessantly reading medical books. By 
no chance did we ever find him wasting his time in idle amuse- 
ment, in frivolous reading, or in listless indolence. I often felt 
myself spurred on to increased diligence by his apparently cease- 
less and indefatigable industry. But, at the time of recitation, 
when we were called on to show what we knew, this young man 
was of the whole class the most deficient in his answers, even 
upon the very subjects of which he had just been reading. He 
seemed to know nothing. And what was the cause of this seem- 
ing anomaly? It was that he simply read; he did not study. 
He allowed his eyes to run over the page, catching the meaning 

15 



226 REQUISITES IN THE STUDY OP MEDICINE, 

if it was obvious, letting it pass if otherwise, and using no efforts 
to make the facts and reasoning his own. The result was that 
he really learned little, and allowed what intellectual energy he 
may naturally have possessed to waste for want of exercise. 

I once myself had a pupil, correct, industrious, and extremely 
desirous to learn. At first I was surprised to find that, upon 
being examined on the subject of his studies, he could scarcely 
answer a question. On investigation, I discovered that he was 
in the habit of simply reading, and did not appear to have the 
conception that anything further was requisite. I then made 
him sensible of the difference between reading and study. I told 
him, in the first place, never to pass a sentence without fully 
understanding its purport, or trying his best to do so ; if he 
should find his attention flagging, and the words slipping through 
his mind without leaving an impression, to return to them again 
and again till he had mastered his own listlessness and the 
difficulties of the subject together ; in the second place, to be 
quite convinced that he had fixed the facts in his memory, and 
to test the point by mentally repeating, at the end of every para- 
graph, or of every page, what he had learned in the course of it; 
and, lastly, not only to follow the thread of every intellectual 
process, but to examine it carefully, to exercise his own judg- 
ment upon it, and to satisfy himself, as far as his present lights 
permitted, of the soundness of the reasoning, and the correctness 
of the conclusion. The advice I gave to him, gentlemen, I. im- 
pressively give to those of you who have not yet formed their 
habits of study. He listened to what I said, became an excel- 
lent student, and afterwards a highly successful practitioner. 
Should the same happy result follow to any one of those who 
now hear me, this little anecdote will not have been told in vain. 

But, in referring to the subject of preliminary preparation, I 
had in mind not so much the general education antecedent to 
the study of medicine, as that portion of the study of medicine 



REQUISITES IN THE STUDY OF MEDICINE. 227 

itself which ought to precede attention to the theory and prac- 
tice. The commencing student is wholly unprepared for efficient 
application to this subject. The child might as well undertake 
to read without having learned his alphabet ; or the youth to 
practice the higher processes of arithmetic ignorant of his multi- 
plication table. You must plough the ground, before you can 
expect profitably to sow the seed. How can you possibly under- 
stand diseased structure, until familiar with the same structure 
in health ; or diseased function, until you know something of 
normal function ? The studies of anatomy and physiology are 
indispensable prerequisites to that of the theory and practice. 
Not less essential is a knowledge of materia medica ; for it is ob- 
viously impossible to learn how to treat disease properly, with- 
out an accurate acquaintance with the instruments employed. 
Chemistry is another important preliminary study, the value, I 
should say the necessity of which, I wish strongly to impress 
on your convictions ; and the more so as it is but too frequently 
underrated. Always important as a branch of medical science, 
it has within a few years become greatly more so, in consequence 
of discoveries in the section of organic chemistry, and the appli- 
cation of these discoveries to physiology, pathology, and thera- 
peutics. They can have no claim to be considered as accomplished 
physicians, who are ignorant of the general principles of chemistry, 
and of such of its details as have a direct bearing upon medicine. 
In speaking thus of these preliminary branches, I am using no 
terms of exaggeration, but laying before you the simple truth. I 
would beg of you to neglect none of the studies mentioned, under 
an impression of the greater importance of that which I teach, 
and its stronger claims on your notice. It is true that the theory 
and practice is the great structure, of which the others are only 
the foundation ; but without these it can have no useful exist- 
ence; and, where all are essential, it cannot be said that one is 
really more important than another. It would be as easy to fly 



228 REQUISITES IN THE STUDY OF MEDICINE. 

without wiogs, or to run without legs, as to acquire a competent 
knowledge of the theory and practice of medicine, without a pre- 
vious acquaintance with anatomy, physiology, chemistry, and 
materia medica. 

I do not say that you are altogether to avoid the subject of the 
practice, until fully prepared on the preliminary branches. What 
I do mean is, that you are not regularly to commence its study 
until thus prepared. You may, without disadvantage, occa- 
sionally read in practical works, and listen to practical lectures, 
at any period of your studies, in an incidental way, and as a 
temporary relief from drier subjects ; you may thus even gain a 
knowledge of facts and terms which shall afterwards render the 
subject somewhat easier: but you should not allow the regular 
course of study to be materially broken in upon by such excursive 
indulgences ; you should take care not to be seduced by the de- 
ceptive notion, that you are doing anything more than somewhat 
beneficially recreating yourselves from the real hard work, neces- 
sary to make you what you are aiming to be. 

3. But let us suppose that the student has thoroughly pre- 
pared himself for entering on the theory and practice. What 
course is he then to pursue? First, he should select some gen- 
eral treatise on the subject, and study this thoroughly, either 
under the private instruction of a competent teacher, or, what is 
still better, in connection with a course of lectures. Such aids 
are of vast importance. They point out what is most essential, 
explain difficulties, obviate errors, test knowledge, and incite to 
diligence and close attention. 

Allow me, under this head, to say a few words in relation to the 
course of lectures I propose to deliver. First, you will under- 
stand that they profess to be merely aids to a system of reading, 
and not substitutes for it. In a number of lectures from 80 to 
100, of an hour each, it would be utterly impossible, with the 
utmost compression, to introduce everything in relation to the 



REQUISITES IN THE STUDY OP MEDICINE. 229 

practice of medicine with which the physician ought to be ac- 
quainted. It appears to me that the legitimate scope and aim of 
such a course of lectures is, in the first place, as far as possible 
to give general facts or principles, through which the student 
may himself arrange individual facts, and deduce correct con- 
clusions in individual cases; and then, in enumerating, describ- 
ing, and otherwise treating of special diseases, not to give minute 
details, filling up and colouring to the life every little trait and 
shade of the picture, but to call attention to the important and 
characteristic points, to fix in the recollection of the student the 
landmarks, by a knowledge of which he may direct his own 
steps through the intricacies of the subject. Upon this plan, a 
course of the extent referred to mav be made to embrace the 
whole circle of diseases belonging properly to this department. 
It is the plan which I propose to follow in conducting the ensu- 
ing course. 

I scarcely need tell you that another principle of my plan of 
teaching is to be as far as practicable demonstrative; to illustrate 
to the eye by diagrams, pictures, models, wet preparations, in- 
struments, etc., whatever is susceptible of such illustration ; and 
I appeal to those who may have attended my previous course, 
whether there is not in our subject a vast deal capable of being 
thus treated, and whether, on a great many points, much more 
vivid impressions may not be made by these auxiliary means 
than by words alone. 

I would repeat, that the prominent objects at which I aim, in 
conducting my course of lectures on the practice, is to render 
them comprehensive and illustrative; and it is in these respects, 
if in any, that they may claim to be peculiar. 

In following the course, your plan will be to recollect as far as 
possible the facts, processes of thought, and deductions; if you 
have great facility in writing, to take such notes as may tend to 
aid your memory in recalling the more important points; and 



230 REQUISITES IN THE STUDY OF MEDICINE. 

then, in the internals of the lectures, to read upon the subject in 
the text-books. 

I have always considered a system of examinations, in con- 
nection with courses of lectures, as highly important. However 
great may be the zeal of the student, the consciousness that his 
proficiency is about to be put to the test, will increase his powers 
of attention, and, I may go so far as to say, even his will to 
attend. He thus absolutely learns more from the lectures them- 
selves than he would do without such a stimulus. Nor is this 
all. The prominent facts being presented a second time to his 
notice, if recollected, will be still more firmly fixed in his memory, 
and, if not recollected, will be so impressed on him that he will 
afterwards be much less liable to forget them. Besides, misun- 
derstandings of what was said in the lectures are by this mode 
of rehearsal corrected; and difficulties, not sufficiently explained 
or accurately comprehended, may now often be rendered per- 
fectly plain to the understanding. These are truths which I 
have had innumerable opportunities to verify. I have been in 
the habit of conducting medical examinations now for more than 
forty years, and consider them in the highest degree valuable in 
a course of medical tuition. 

4. But now let us suppose that you have thoroughly studied 
a systematic treatise or treatises on the practice of medicine, and 
have derived all the advantages possible from attendance upon 
courses of lectures on the subject. You are not on this account 
to consider your studies as completed. You have in fact only 
laid the foundation, and erected the frame-work of your future 
knowledge. You have yet to do the filling up and finishing of 
the structure. For this purpose you are now to leave the gen- 
eral treatise, and turn your attention to monographs on special 
diseases, or treatises on certain sets of diseases having some 
common bond of union. These you are prepared by this time 
thoroughly to understand, and in great measure to appreciate. 



REQUISITES IN THE STUDY OP MEDICINE. 231 

Not only will you thus acquire a greater mass of facts, and be- 
come conversant with different views, but will learn to think for 
yourselves. You will escape the dangers of an indolent reliance 
upon the thinking of other people, of pinning your faith to the 
sleeve of any man, of swearing by the words of any master. 

It is believed by some that the present mode of teaching, by a 
system of reading and examinations, has the injurious tendency 
to stifle all independence or originality of thought, to make the 
student familiar with a certain routine of facts and formulas, 
and to give him the impression that nothing more is needful; in 
fine, to make of him a mere instrument for carrying into practice 
in communities certain cut and dried notions that have been 
packed into him — a kind of medical sowing machine, that shall 
scatter its seeds, in the same proportion, over all sorts of ground, 
in all states of preparation. It must be admitted that such might 
be its influence, if instruction were carried no further. But we 
are not to suppose that the student is to stop here ; and, for fear 
that he should stop here, we are assuredly not justified in advis- 
ing him not to proceed thus far. As well might you avoid 
teaching a child the grammar of a language, for fear that he 
might ever afterwards speak and write with the stiff formality 
of rules. No ! This exact mode of instruction is of vast im- 
portance by giving accuracy and precision to knowledge and 
thought. Without it, trusting merely to himself, the student 
would be apt to be inaccurate in attainment, loose and discursive 
in his reading and thinking, culling the flowers only as he pro- 
ceeded, indulging the imagination rather than disciplining the 
reason, and withal acquiring a self-confidence and self-reliance, 
very proper and very useful when based on correct knowledge 
and mental discipline, but a curse to himself and those who 
trust him, when connected, as they too often are, with real 
ignorance and inexperience. 

Neither plan, then, is exclusively right; neither that of sys- 



232 REQUISITES IN THE STUDY OP MEDICINE. 

tematic study under constant superintendence, nor that of dis- 
eursive reading without experienced guidance. The two should 
be combined, and the former should always precede the latter. 
Accuracy and precision may thus be attained, and a mechanical 
routine avoided. 

As to the particular special treatises that you should read, or 
the order in which they may be read, no very precise rule is 
necessary. The choice may very well be left to the judgment 
and taste of the previously instructed student. It will certainly 
be more or less influenced by his opportunities, his predilection 
for one or another specialty in our science, and the character of 
the disease or diseases which may come under his notice, and 
which he may desire to investigate. And this leads me to 
another, and the last step in the education of the medical prac- 
titioner. 

5. You have heard much of clinical instruction ; and you can 
scarcely have heard its importance overstated. To show disease 
by the bedside is the true mode of demonstrating it. Until you 
come to the practice of your profession, you can with difficulty 
conceive how essential the personal observation of disease is to 
the proper understanding of it, and how little the notions often 
formed from reading or oral instruction correspond with the 
reality. The young physician who engages in the business of his 
profession, without this previous preparation, finds himself at a 
loss in recognizing the most common diseases ; and it is only 
after frequent trials, and not unfrequent blunders, that light at 
last breaks upon him, and he begins to learn to diagnosticate in 
practice as well as out of books. To recognize and treat a com- 
plaint well, without ever having seen it, or anything like it, 
would be as difficult as to make a coat or a shoe, after having 
been taught by description the various steps of the process, with- 
out having seen it put into practice. 

From the very commencement of your studies, you should 



REQUISITES IN THE STUDY OF MEDICINE. 233 

embrace every occasion to become practically familiar with dis- 
ease. Like the botanical student who, in all his excursions, 
whether of pleasure or business, seizes eagerly on every unknown 
plant along his path, and plucks it for examination; so should 
you be ever on the watch for the objects of your own pursuit, 
and, whether in town or country, by day or night, in the search 
of enjoyment or the performance of duty, catch each fleeting op- 
portunity, and gather as much as you can of the good which it 
offers. Of course, your first impressions will be vague and un- 
satisfactory ; but you will be acquiring a practical knowledge of 
the pulse, of the various appearances of the tongue, of the colour, 
temperature, and other qualities of the surface, of the expression 
of the face, etc., which will be of great service in your subse- 
quent studies, as well as in your clinical observations. You 
should also explore the sounds of the chest and the heart, and 
practise percussion and auscultation upon the well and the sick, 
the young and the old ; and, though I would not advise you, in 
all your social intercourse, to be watching your friends of either 
sex thus professionally — to slide your fingers from the palm to 
the pulse at every greeting, to count the respirations when you 
ought to be listening to the words, or to think of the heart tech- 
nically whenever you may happen to feel or to witness its throb- 
bings — yet there are frequent occasions when all this may be 
done with very great propriety, and no less profit. To procure 
such opportunities, you should be ever ready to aid in the per- 
formance of the offices, so often called for in the care of the sick ; 
to sit up with them at night, to prepare and administer their 
medicines, to make the various external applications, to arrange 
their positions, to bleed, leech, cup ; in a word, to do everything 
that may tend to familiarize you with the duties, which, if you 
do not actually have to perform in future, you will certainly have 
frequent occasion to direct and superintend. 

It is especially, however, while studying the practice, that you 



234 REQUISITES IN THE STUDY OF MEDICINE. 

should seek for opportunities of observing actual disease in all 
its relations. Those of you who pursue your studies in rural 
situations have a fine field open to you in the practice of your 
preceptors, whom you may often materially aid, while benefit- 
ing yourselves, by an occasional visit to his patients when he is 
overburdened, and by rendering those numerous offices about 
the sick which nurses cannot always be found competent to per- 
form, yet the due performance of which is scarcely less essential 
to a favourable issue than the prescription of the physician him- 
self. Allow me, in this place, to offer a hint which may not be 
useless in reference to your ultimate interests. When acting as 
nurses, you should endeavour to sink self in the office, to make 
the patient the main if not exclusive object of concern, and scru- 
pulously to avoid all those levities, which, however excusable in 
youth under other circumstances, are certainly out of place in 
the presence of human suffering, of danger, perhaps of death. 
Appropriate deportment under such circumstances, not only the 
proper performance of professional offices, but a becoming sym- 
pathy with the patient and his friends, will, you may be assured, 
be remembered to your advantage ; while a contrary course may 
leave an unfavourable impression, which the whole future life may 
not entirely efface. I know well that youth cannot make the ex- 
perience of age its own ; but, when the proper disposition exists, 
when the soil of the heart is good, a word of admonition duly 
planted may take root, and spring up to ultimate profit. 

For those who study in large towns, abundant clinical oppor- 
tunities are usually afforded in hospitals, dispensaries, and other 
public institutions, which a student would be quite unpardonable 
in wholly neglecting, if he have any view ultimately of taking 
upon himself the care of the sick. Undoubtedly, the most effi- 
cient method is to visit the sick-bed along with a competent in- 
structor, and there thoroughly investigate the case. To the zeal- 
ous more or fewer of such opportunities are generally presented. 



REQUISITES IN TIIE STUDY OP MEDICINE. 235 

It is true they must be sought. You must put yourselves in the 
way of catching the fleeting chances as they offer. They will 
certainly not follow and hunt you up in your private places of 
abode or of resort. But recollect, gentlemen, that years hence, 
you will often bless the perseverance and self-denial which you 
may now exercise in this sphere of duty. 

Next in advantage to these private bedside studies, is attend- 
ance upon the clinical instruction, provided in hospitals for classes 
of students. When large numbers of young men are to be taught 
at the same time, it is obviously impossible that they should be 
advantageously taken from bed to bed in the wards. I have tried 
this plan, and know it from experience to be productive of little 
good to the pupil, while it is often greatly oppressive to the pa- 
tient. The confusion, the noise from shuffling feet, the impossi- 
bility of hearing in the outskirts of the crowd what may be said 
by the prescriber, and the want of due access to the bed, often 
counteract and neutralize all the good produced. The proper 
method is to collect the audience in a suitable apartment, and to 
bring the patient before them at a point whence he can be seen 
by all, and whence the lecturer, stationed at his side, can be 
heard by all. By this plan the learner is enabled to bring all the 
requisite faculties, except only the sense of touch, to bear upon 
the case presented. The teacher has the opportunity to demon- 
strate the disease, with the certainty that at least most of what 
he points out will be seen, and that all that he may say will be 
heard. He is, moreover, enabled to make a selection of cases 
from the wards, to bring forward together those which are analo- 
gous, or have important mutual relations, and thus to present his 
facts and reflections to the student in a succession, which will 
greatly increase their impressiveness, and cause them to be more 
easily recalled by the memory when needed. Many of you are 
aware that this is the plan adopted in the Pennsylvania Hospi- 
tal, the only one in fact at all applicable to the circumstances in 



236 REQUISITES IN THE STUDY OP MEDICINE. 

which that institution is placed, in relation to medical instruction, 
in the winter season. 

I need not urge on you the importance of attending the clini- 
cal instruction thus offered. In ours, as in many other medical 
schools, such attendance is made obligatory on all candidates for 
the degree. Wherever practicable, it is I believe considered, 
both in this country and Europe, as an essential part of medical 
education. In a rearrangement of the fees which took place 
some years since in the medical department of the University, 
the price of the Hospital ticket, over which our school has no 
control, was deducted from the amount of the graduation fee, so 
that, though paid by the student, it should in reality cost him 
nothing. I revive the remembrance of this fact in order to show 
the estimation in which clinical instruction is held by those who 
regulate the concerns of our institution. Indeed, the advantages 
of this most efficient method of demonstrating disease, whether 
attained through hospitals, dispensaries, or in the walks of pri- 
vate practice, can scarcely be overrated; and the day, I hope, 
will come, when they shall be so clear not only to the profession 
but to the public generally, that all will unite in throwing open 
as widely as possible to the students of medicine the portals of 
every avenue that can lead to their attainment. 

With these observations I close the advice I had to offer you. 
I am well aware that to many of you, much of what has been 
said is quite superfluous ; but if they by whom the paths of 
medical study have but just been entered, and who may be still 
somewhat embarrassed by the novelty of their position, should 
derive any advantage from them, my purpose will have been 
fully answered. Even those of you who least need the lessons 
will, I know, excuse them, when you reflect that they proceed 
from one old enough to be your father, and whose experience in 
medical teaching began, before the greater number of those who 
now hear me had seen the light of this world. I have endeav- 



REQUISITES IN THE STUDY OF MEDICINE. 237 

oured to make them plain and simple, aiming at no ambitious 
ornament, but solely to be understood, and to be impressive. 

I once more, gentlemen, welcome you to these halls, and on my 
own part, as well as on that of my colleagues, assure you that 
no pains of ours shall be spared, in promoting the great purpose 
for which you have come, and in rendering you whatever aid may 
be necessary to make you all that vour best friends could wish. 



LECTURE III. 



DELIVERED OCTOBER 14th, 1S5S, 



Character and Objects of the Medical Profession. 

Accept, gentlemen, my cordial greetings. Allow me also thus 
early to bespeak your friendly sentiments, in return for those 
which I offer you. Reciprocal kindliness of feeling will greatly 
lighten the burden of our coming duties ; and I am not without 
the hope, that the labour which might otherwise be looked upon 
as a task, may become a real pleasure, under the cheering influ- 
ence of mutual good-will, and hearty co-operation. 

I am to be your guide, my young friends, through the intrica- 
cies of practical medicine, which now lies before you like a 
seeming wilderness. I hope to be able not only to make your 
path plain, but to show you that what, to the inexperienced eye, 
may seem a tangled labyrinth, is in fact a wisely planned system 
of harmonious and beneficent order. I hope, too, though your 
journey will be necessarily toilsome, to lead you into many grate- 
ful and refreshing scenes; through grassy glades, by cool rivu- 
lets, beneath the shadow of magnificent groves, where the sense 
of weariness or fatigue may be lost in that of the beautiful or 
grand, and the sweat of your brows be fanned away by the 
sweet breath of nature. 

Yet, before we enter together this scene of mingled labour 
(238) 



CHARACTER AND OBJECTS OP THE MEDICAL PROFESSION. 239 

and enjoyment, I have a duty to perform. I must tell you what 
lies beyond it. I must endeavour to give you some knowledge 
of that wider field of practical dut\ r , to which the course of study 
you are about to enter is merely preliminary. But it is not my 
intention to represent to you specially either its attractive or 
repulsive qualities. Having already enlisted under the banner 
of medicine, you need no allurements to entice you onward, and 
are not likely to be alarmed into desertion by any picture of the 
possible evils to be encountered. My aim is only so to place 
before you the character and objects of your future profession as 
to enable you to appreciate its requisitions, and to stimulate you 
to every needful effort. 

1. Prominent above all other points is the consideration, that 
the medical profession is not to be regarded as a mere business; 
as the means of securing a livelihood, or accumulating a fortune; 
as an instrument for the attainment of any object whatever of a 
purely selfish character. Reflect for a moment on the great ends 
which it proposes ; the relief of human suffering, and the pre- 
servation of human life. To live, and to be exempt from bodily 
pain are, upon the whole, the two greatest earthly blessings of 
man. It is true that they are often put at risk in the pursuit of 
other objects. In the spirit of the gambler, we recklessly stake 
them in the vast games of the passions ; in the spirit of the 
martyr, we sometimes offer them up at the shrine of duty; but, 
in the former case, the loss of the game is despair ; in the latter 
there is simply an exchange of a temporary for an endless bless- 
ing, of life and its comforts here, for an eternity of happiness 
hereafter. What arc all the good things of this world without 
health to enjoy them ? and what boots it, if we gain wealth and 
power, or attain our immediate ends in the pursuit of any other 
secular object, and at the same time lose our own lives, upon 
the continuance of which hangs all the pleasure of success? 
What is the highest cruelty of which man can be guilty, the 



240 CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 

characteristic in which he approaches nearest to the beast of 
prey, if it be not the infliction of bodily torture ? Why is it that 
a cold shudder creeps through us at the very name of the inqui- 
sition ? What gives to the North American Indian the atrocious 
pre-eminence among savages, which the holy brotherhood holds 
among civilized men ? Is it not that the slow anguish of the 
stake is the highest conceivable degree of human suffering? 
Say what we will of mental torture, how few there are who are 
willing to escape it, at the cost of even a comparatively brief 
torture of the flesh ! 

If, then, bodily ailment and the loss of life are the greatest of 
worldly evils, how noble must be that pursuit whose purpose is 
to obviate them ! How great the responsibility of those who 
undertake its duties ! This is the light in which our profession 
should be habitually viewed by all its votaries. In entering it, 
we assume an obligation to devote ourselves to its high func- 
tions. This should be the prominent feeling of every medical 
student and practitioner. How powerful the stimulus thus 
offered, in every well-constituted mind, to industry and zeal in 
the work of preparation ! With the medical student, it is not a 
question, as with the mere worldly neophyte, whether be shall 
personally gain or lose in proportion to his industry or negligence. 
Were this the only consideration, he might often, under strong 
temptation, reconcile himself to inattention and idleness, upon 
the ground that his conduct is purely a matter of expediency; 
that, if he choose, for present gratification, to sacrifice a portion 
of future good, no one has a right to complain, as no one but 
himself can be affected. It is true that, even in reference to sordid 
interests alone, this reasoning would be unsound. But it is not 
without some plausibility, and might not be without effect. But 
in the higher view here taken of the scope of the profession, 
which beyond all controversy is the just one, such an excuse 
could not be offered to the most obtuse conscience. The student, 



CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 241 

habitually keeping it before his eyes, could never give way to 
the temptatiou of idleness, or distracting indulgence, without a 
consciousness of neglected duty. He would feel, when yielding 
unduly to enticement, that he was inflicting evil on others ; that, 
in failing to use all diligence in qualifying himself for his pro- 
fession, he was, in the same proportion, doing injury to his 
prospective patients, repaying their good-will and confidence 
with suffering and perhaps death, and laying up remorse for his 
own future. 

Fix, then, indelibly in your minds this high conception of your 
future office, and let it mingle with and pervade all your pro- 
fessional thoughts. Consider yourselves not as traffickers in the 
pursuit of gain ; not even as mere aspirants for honourable dis- 
tinction ; but as men destined by Providence for the performance 
of a great duty ; a kind of priesthood, set apart and anointed for 
a peculiar and sacred function, to which belong, in a considerable 
degree, the issues of happiness and misery, of life and death, and 
in which unfaithfulness, either in promise or performance, is an 
offence not against man only, but the Most High. 

The habitual cherishing of such a sentiment will have other 
important effects, besides those of encouraging diligence in the 
pursuit of professional . knowledge. It will have an elevating 
and ennobling influence upon your character. One lofty senti- 
ment, habitually entertained, acts like a ferment, leavening, in a 
greater or less degree, the whole soul into its own nature. 
There is happily a contagion of good as well as of evil. Simply 
realize the fact, that, by entering the medical profession, you 
bind yourselves to devote your best energies to the good of your 
fellow-men, so far as life and health are concerned ; and the 
simple consciousness will raise you above what is sordid or 
grovelling. You will feel yourselves invested with a moral 
dignity and self-respect, as with a robe of ermine, which will 
cause you sedulously to shun every soiling contact. 

16 



242 CHARACTER AND OBJECTS OP THE MEDICAL PROFESSION. 

Picture to yourselves a man who becomes a physician from 
purely sordid motives. In the first place, he is probably insuffi- 
ciently prepared, because he has been without sufficient induce- 
ment to the requisite exertion. In the second place, as his wish 
is not so much to cure disease as to make money, the former ob- 
ject will yield to the latter, when the two are incompatible. He 
is likely, therefore, at once, to be an unskilful practitioner, and 
not to employ to the best advantage, therapeutically, the knowl- 
edge he may possess. He looks upon his unfortunate patient 
simply as a customer. Allow him to be at first so far an honest 
man as to be disposed to sell the best that he may have at a fair 
price. This disposition cannot long continue. The tendencies 
of his mercantile position will always be, to make as much 
money with as little expenditure of time and trouble as possible. 
The resistance of evil requires the constant support of strong 
principle, with the careful avoidance of all seductive influences. 
Among the petitions that we are directed in Holy Writ to offer 
to our Father who is in Heaven, is that we may not be led into 
temptation. A physician with no other than sordid motives is 
unceasingly and voluntarily exposing himself to influences which 
he is thus taught to shun. The prayer against temptation can, 
under such circumstances, be of no possible avail. It would be 
as though we should beseech to be saved from poison, while of 
our own accord swallowing arsenic. The sordid tendencies would 
undoubtedly predominate, and, unless in a mind extraordinarily 
well constituted by nature, would be apt in the end to gain 
unresisted sway. 

Let us trace the probable course of the mere trafficking doctor. 
It differs somewhat under different circumstances ; but on the 
whole is inevitably downward. Suppose him to have a fair 
start, in an unoccupied field, and without competition. At first, 
if not already corrupt, he may aim to practise fairly, giving to 
each case its due amount of attention, and demanding only a 



CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 243 

just remuneration. But he soon begins to find, or at least to im- 
agine, that he is not making the most of his opportunities. He 
learns that he may gain more, with less cost of time and labour. 
His visits to the patients who can pay little gradually become 
fewer ; to those who can pay well gradually more frequent ; for 
he is paid by the visit; and he begins to think that no one is 
entitled to attention he cannot pay for, a whit better than to a 
pair of shoes or a pound of bread below cost. As it happens, 
this is lucky for the poor man affected with a spontaneously 
curable, or easily treated disease ; for he gets well with little 
medicine and at a small expense. But woe to him if seriously 
ill, and in need of incessant and careful attention. Woe, too, to 
the rich man in pocket and in health. His is a- case to be cher- 
ished. He receives visits, it is true, in abundance, and doses 
without number ; but there is no corresponding amendment. 
He may at length get well ; for nature often cures in spite of 
the doctor; and, besides, the conscience is not yet absolutely 
hardened to murder ; and even interest requires that the sheep 
already fleeced should be kept for another shearing. Some at- 
tention, moreover, is necessary to reputation; and the patient 
and his friends must not be scared off by suspicions, either of 
deficient skill, or of foul play. The duration of the case, there- 
fore, so far as it depends on the doctor, is a matter of somewhat 
complex calculation. On the one side are the dollars ; on the 
other, some remains of conscience, a prudent regard for reputa- 
tion and future opportunities, and, perhaps, a sickly season. 
Professional duty and the welfare of the patient are not taken 
into account. 

But let us suppose that competition springs up, or has existed 
from the first. He has now a double game to play. Gold must 
be won, and the rival undermined at the same time. There may, 
under these circumstances, be more caution in practising tricks 
of trade ; for a watchful and knowing eye is upon his move- 



244 CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 

ments, and a fair seeming is essential to success. Here the 
sordid spirit shows itself in endeavours to depreciate the rival 
by disadvantageous comparisons, false insinuations, or even 
direct falsehood. Offence is thus given to the medical brother, 
however correct and high-minded he may be; and hence un- 
seemly disputes, which disgrace the individuals concerned, one 
or both, and injure the profession generally in public esteem. 

Perhaps, instead of regular competition, some variety of quack- 
ery comes upon the stage ; and the public mind is thrown into 
excitement by the novelty, or the flaring pretensions of the new 
practice or doctrine. Our doctor, if quite lost to all principle 
and self-respect, and surrendered, body and soul, to mammon, is 
now apt to set his sail to the popular breeze, and to meet the 
new rival with his own weapons. Perhaps he proclaims himself 
a convert, and professes to practise on the novel plan. Perhaps 
he goes only half way, and, medical demagogue as he is, declares 
his submission to the will of the people, and engages to cure 
them in whatever way they may deem best, whether by homoeo- 
pathic globules, by sweating and red pepper, by cold water, or 
in the old accustomed method. 

There is yet one further step in the ignoble descent. His 
cupidity is excited by the reported success of some renowned 
advertising doctor. He hears of this or that pill-vender, or 
nostrum-monger, as having accumulated boundless wealth, and 
living in corresponding magnificence. Visions of similar pros- 
perity present themselves to his inflamed imagination. He is 
aware that a gulf of infamy lies between him and the realization 
of the splendid picture. He nevertheless takes the last desperate 
leap into the slough before him, and either sinks dishonoured, or 
rises up, clutching the coveted prize, but covered all over with 
the filth of degradation, which, though he may endeavour to 
conceal it with the splendour of his fortunes, no subsequent 
cleansings can remove, save only the washing of regeneration. 



CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 245 
i 

I have thus endeavoured to sketch the gradual descent to 
which they are liable, who, in the practice of medicine, start 
with the sole object of pecuniary advantage. You may think 
that I have spoken strongly. But consider simply the conse- 
quences of deviation from the path of rectitude in medicine. 
Recollect that human life is at stake. The world and even the 
profession are apt to look upon this thing too lightly. They 
often speak of success or failure, as of the same results in other 
pursuits, and make a jest of quackery as they would laugh at a 
juggler. But this conversion of medicine into a trade is no 
laughable matter. Language, in my estimation, is scarcely 
strong enough to express its intense criminality. Life is put 
at hazard, not unfrequently sacrificed for a little money. Let 
me not be told that there is no murderous intent. There is at 
least full knowledge that death may ensue ; and, if it take place, 
in what is the manslayer less guilty than if it had been purposed ? 
It may be said, in extenuation, that the patient is not so often 
positively killed by the treatment, as allowed to die from the 
omission of proper means of safety. There is scarcely the differ- 
ence of a hair's breadth between the cases. In what respect is 
the practitioner, who neglects means which he may believe to be 
necessary, because in opposition to his supposed interest, less 
criminal than another, who, under similar influences, administers 
a medicine, knowing that it may prove deadly ? Both are equally 
guilty , and neither, in my conception, better than the robber 
who kills you for your purse, or the assassin who deals the fatal 
blow for a fee. Nay, the latter, if not less guilty, are less mean- 
spirited ; for they place their own lives at hazard, while the 
medical homicide cowardly sneaks to the same end under the 
safe cover of the law. You may understand how, with these 
views, I can feel only disgust or abhorrence for such unprinci- 
pled men, however apparently prosperous their fortunes, and 
under whatever hypocritical disguise they may conceal their 
moral deformity. 



246 CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 

i 

The proportion of those who, having been regularly educated 
as physicians, sink to this depth of depravity, is happily very 
small ; but such is the tendency in every instance, in which the 
true aim and scope of the profession are lost sight of in eager- 
ness for gain ; and, though many may be arrested in various 
stages of the descent, no one is exempt from the danger of utter 
degradation who has once entered the downward path. 

Even men w 7 ho may succeed to their heart's content, in the at- 
tainment of practice and its pecuniary rewards, find that, after 
all, this is but poor compensation for their necessary labours and 
privations. Worn by days of labour, and sleepless nights ; in- 
terrupted at meals, or in the rare enjoyment of social pleasures ; 
breasting the midnight storms of winter, or sweltering in sum- 
mer's noonday sun; fretted by conflicting claims, jarring profes- 
sional views, the reproaches of disappointment or discontent, 
the misrepresentations of envy, malice, or opposing interests; 
can the medical practitioner, thus suffering from bodily and 
mental discomforts, find adequate compensation in the mere 
swelling of his hoard of dollars ? Xo, gentlemen ! Were this 
his only source of comfort, he would be wretched in the midst 
of accumulation. Something more is necessary to yield him an 
adequate recompense. This he finds, and can find only, in the 
consciousness that he is fulfilling a high duty, and is thus laying 
up treasures where neither moth nor rust corrupts. 

But, while thus endeavouring to bring before you the un- 
speakable evils of a purely mercenary spirit in the practice of 
medicine, it has been far from my intention to lead you to un- 
dervalue the claims of the physician to a just remuneration. 
As in other avocations, so also in medicine, the practitioner 
must live by his labour. Being, from the necessities of his posi- 
tion, the associate of men in the highest walks of life, he must 
earn through his profession the means of supporting a conform- 
able style of living. The capital expended in qualifying himself 



CHARACTER AND OBJECTS OP THE MEDICAL PROFESSION. 247 

for his pursuit must be repaid. He is, moreover, justly entitled 
to such a professional income as may enable him, after a success- 
ful career, when his mental and bodily powers begin to fail, to 
withdraw from active duty, not only with a competence for his 
old age, but with a suitable provision for his family. His com- 
pensation, therefore, must be on a liberal scale. Experience de- 
termines what is necessary on the basis of calculation just stated; 
and in all communities prices arrange themselves as a neces- 
sary result of existing circumstances. Two evils are to be 
avoided, both generally flowing from the sordid views against 
which I have endeavoured to guard you, and both having a de- 
basing influence on the profession. One is that of underselling, 
by which a mercenary practitioner hopes to prosper at the ex- 
pense of his professional neighbours. This is justly regarded 
by the mass of medical men as mean and discreditable ; and he 
who notoriously practises on this principle loses more in the 
good opinion of his fellows, and of high-minded men generally, 
than he can possibly gain in a pecuniary point of view. The 
other evil is that of extortionate charging, by which a medical 
man brings discredit both on himself and the profession, and, in 
fact, though he may gain for the present, is apt to be a loser in 
the end. To avoid these extremes, it is customary for medical 
communities to determine the proper compensation for profes- 
sional service in their several neighbourhoods, and thus to fix a 
standard, any material deviation from which would be regarded 
as discreditable. But great latitude is necessarily allowed, in 
consequence of the varying circumstances of the sick; and, 
whenever the regular charge would be oppressive, it is not only 
admissible, but even right, and I think, morally obligatory on 
the practitioner, to make corresponding allowances. Indeed, a 
necessary consequence of the view of professional duty that I 
have presented, is that we must, if in our power, even attend 
the sick gratuitously, when they are without the ability to com- 



248 CHARACTER AND OBJECTS OP THE MEDICAL PROFESSION. 

pensate us, and no other means of relief are at their command. 
If the practice of medicine were a mere traffic, these rules would 
not be necessary. Like other trades, it would prosper most 
when quite unrestricted. The simple rule then would be that 
every physician should make as much out of his opportunities 
as possible ; and that his services should never be called into 
requisition, when they cannot be paid for. In our view, on the 
contrary, his services should be rendered whenever a necessity 
for them may exist, and the compensation be made a secondary 
consideration. 

The same may be said of good-will, reputation, distinction, 
fame, as the reward of medical service. These are certainly al- 
lowable and even praiseworthy motives of action. They may 
be looked on as of a higher character than mere gain. The 
student who pursues them through a laborious course of prepa- 
ration, and the practitioner who wins them by continued efforts 
after higher qualification, and the diligent performance of his 
practical functions, assuredly stand upon higher ground than 
he who aims only at the dollar. But they should ever he re- 
garded as secondary, and subordinate to the great principle of 
duty. 

If without irreverence we may quote the Scripture declara- 
tion, " seek first the kingdom of God and his righteouness, and 
all these things shall be added unto you," I would say that, 
what this divine injunction is, in its religious bearing, is the 
analogous injunction in our professional relations ; seek first to 
perform your duty to the sick, and all else that is needful or 
desirable, whether pecuniary reward, the affectionate regard of 
others, or general reputation, will follow as an almost necessary 
consequence. 

2. We have hitherto been considering the profession in re- 
lation to its ends. But there are other points of view, in 
which it must be regarded by those who desire to fulfil all its 



CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 249 

requisitions, and to bring themselves into exact conformity with 
its character. 

It is, you know, universally ranked among the learned pro- 
fessions. Some acquaintance with the natural and physical 
sciences is essential to the physician as a mere practitioner ; but 
more than this is expected. Like other men of liberal educa- 
tion, he is supposed to know something of the past; to be more 
or less conversant with historical deeds and characters, with 
opinions which have influenced the course of human events, 
with the great productions of genius in literature, philosophy, 
and the arts. He must, moreover, not be quite ignorant of the 
existing condition of the world ; of the races of men and their 
distribution; the divisions of the earth and its "products ; inter- 
national relations; the principles of government; the state of 
learning and science ; the great interests of agriculture, manu- 
factures, and commerce. These are subjects to which every 
educated gentleman is presumed to have paid more or less atten- 
tion, and gross ignorance of which would, as a general rule, be 
considered as evidence of neglected intellectual culture, and con- 
sequent incapacity for duties, which, like those of practical 
medicine, peculiarly call for the exercise of intellect. 

It must be admitted that the vulgar often estimate a physi- 
cian's professional abilities by a different standard. They are 
apt to consider medical qualifications as a gift. These, they 
often think, come by nature, like supernumerary toes or fingers. 
A natural bonesetter takes precedence, in their estimation, of a 
Dupuytren, Sir Astley Cooper, or Dr. Physick. A seventh son 
is a born doctor ; and the seventh son of a seventh son, is a very 
miracle in the art of healing. Now, as the vulgar may be found 
among the rich as well as the poor, a practitioner who can in- 
spire such a belief of his extraordinary gifts, may possibly attain 
a profitable practice, especially if possessed of that sort of talent 
which makes a successful juggler or swindler, namely, the talent 



250 CHARACTER AND OBJECTS OP THE MEDICAL PROFESSION. 

of humbug. But he could scarcely pass muster with the think- 
ing and intelligent portion of the community. These, being 
quite ignorant of medicine, can judge of him only by the attain- 
ments he may possess in common with themselves. If they find 
him generally well informed, and of sound judgment in things 
they understand, and at the same time have reason to believe 
that he has been industrious as a professional student, they will 
give him credit for corresponding proficiency in medical knowl- 
edge and skill, and be disposed to seek his aid when the occasion 
offers. You perceive, then, that the physician, possessed of gen- 
eral information, stands a better chance of professional success 
than the mere pretender, or even than one tolerably qualified as 
a practitioner, but ignorant in other repects ; and, at all events, 
should he fail to gain a greater amount of practice, he would 
certainly take a much higher position in the general esteem of 
the communitv. 

Especially is it important that he should not be ignorant upon 
the subjects connected with his professional pursuits, though 
they may have no direct bearing upon the treatment of disease. 
Thus, he should be informed as to the sources of drugs, the 
origin and spread of diseases, and the history of the progress of 
medicine. Independently of his own personal satisfaction, and 
his own self-respect, the possession of this sort of knowledge will 
have a special bearing on the opinion formed of him by others. 
Many persons, ignorant of medicine professionally, have con- 
siderable information on such subjects, and are quite capable of 
detecting the want of it in the physician. It may be readily 
conceived that they would not feel themselves bound to silence ; 
and that an estimate would be formed b}' the community of pro- 
fessional abilities in accordance with the ignorance displayed. 

Suppose, for example, that a young medical pretender should 
inform his hearers, perhaps in answer to testing questions, that 
Peruvian bark is produced in Labrador, and Iceland moss on the 






CHARACTER AND OBJECTS OP THE MEDICAL PROFESSION. 251 

Andes ; that Jamaica pepper grows in the East Indies, and Cey- 
lon cinnamon in the West ; that Galen discovered the anti-vari- 
olous influence of vaccination, and Hippocrates was highly- 
skilled in auscultation and percussion ; that yellow fever is a 
native of Alexandria in Egypt, and the plague of New Orleans ; 
and that epidemic cholera originated somewhere in Kentucky, or 
perhaps in California ; what do you suppose would be the opin- 
ion formed of his real professional attainments ? And yet I have 
often known answ-ers as absurd, given by candidates for medical 
honours. 

You will, then, agree with me in believing that more or less 
general knowledge is essential to the physician, and will direct 
your studies accordingly, not now only, but during the whole 
course of your professional life. I do not here refer to the pre- 
liminary studies requisite in anticipation of the professional. 
This is an extremely important theme ; but it does not come 
within the scope of the present address. I may, however, be 
permitted, so far to allude to it, as to suggest to those among 
you, if there be such, whose early opportunities have not been 
favourable, the propriety of endeavouring, henceforth, as far as 
may be in their power, to supply the deficiency by additional 
labour and diligence. 

But I have as yet offered you only the humblest motives for 
the cultivation of general knowledge, in connection with that 
strictly professional. I have appealed only to your hopes of 
success in obtaining business. But there are inducements of a 
higher nature. An ampler development is thus given to your 
intellectual powers; a wider scope for the exercise of thought, 
and the cultivation of all your better feelings ; a deeper insight 
into the springs of human action, and, as a result of all these 
advantages, a more powerful influence over yourselves, and over 
the thoughts, convictions, actions, and characters of others. 
You are thus elevated in the scale of civilization, are rendered 



252 CHARACTER AND OBJECTS OP THE MEDICAL PROFESSION. 

more useful members of the community in which you live, and 
add to the resources of pure medicine, in the treatment of dis- 
ease, others altogether unknown to the uncultivated man. Some- 
thing more than the knowledge of disease and of medicines is 
neeessary to constitute the greatest skill in the healing art. In 
diagnostic investigations it is often important to enter deeply 
into the mental constitution of the patient, in order to estimate 
the nature and extent of the moral influences that may have been 
concerned in producing, or may continue to operate in keeping 
up the complaint. Nor is it less important, in a therapeutical 
relation, to have the power of applying such influences to the 
modification of disease, either directly, or through the co-opera- 
tion of the mind of the patient with the remedial agencies em- 
ployed. How can all this be done by a physician without mental 
culture ? The respect and confidence of the patient are of im- 
mense importance to the practitioner, by inducing a hearty 
acceptance and full carrying out of a proposed plan of treatment. 
How are these to be gained, at least from intelligent and well 
educated persons, unless they can discover in their medical 
attendant something beyond the dry technicalities and details of 
professional knowledge ? 

Even our own self-respect requires that we should be able to 
associate, on equal terms, with the best instructed of any com- 
munity in which our lot may be cast ; and, in our country, there 
are few neighbourhoods in which sufficient intellectual light does 
not exist, at least in portions of the population, to throw deep 
shadows from extreme ignorance, whether pretending or unpre- 
tending, upon the path of professional success. 

But, while urging the necessity of general mental culture, I 
would put you upon your guard against a course into which it 
may lead you, full of danger to your best hopes. I refer to an 
exclusive or very obvious devotion to any one branch of science 
or literature, which may absorb your faculties and time, and 



CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 253 

withdraw, or seem to withdraw them from your proper profes- 
sional pursuit. Medicine is a jealous mistress, and will bear no 
rival in your affections or attentions. She tolerates and even 
demands such accomplishments as may render her votaries more 
efficient in her service, and reflect additional splendour upon her- 
self. But her deepest frowns await those who acknowledge only 
a divided fealty, or addict themselves preferably to the service 
of another mistress ; and even coquetry often draws down upon 
her professed votary a withering indignation. To success in 
medical practice there are few greater impediments than a real or 
seeming preferable addiction to some other branch of knowledge, 
even though it may be collateral with medical science itself. 
The world, whether justly or not, will believe that time and 
labour must have been unduly abstracted from professional de- 
votion, and will, as a general rule, seek the aid of physicians, 
who, though generally accomplished, have permitted no other 
attachment to encroach visibly upon their legitimate one. Of 
course, this warning is intended only for those who aim at the 
practice of medicine as their pursuit in life. To those, and they 
are not a few, who in the study of medicine are preparing them- 
selves for usefulness in some collateral occupation, to which 
medicine herself is for their purposes only a handmaiden, the 
remarks just made are quite inapplicable. But I would reiterate 
that, if you propose, as your great object in life, a wide field of 
professional duty, you must let it be clearly seen that such is 
your aim, and that whatever else you may have gained through 
opportunity or diligence is to be made subservient to this end. 
To attain eminence as a poet, historian, mathematician, philos- 
opher, even as a chemist or botanist, if not fatal to your views, 
will very greatly impede their fulfilment. 

3. Without further pressing the subject of general literary or 
scientific culture, I would call your attention to another profes- 
sional requisition, of considerable, if not equal importance. Phy- 



254 CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 

sicians necessarily associate with all classes of the community, 
from the coarsest to the most refined. They come, moreover, 
into the closest relations with individual peculiarities, unpro- 
tected by the defences which are thrown about them in ordinary 
social intercourse, and liable to be irritated or wounded by rough 
or uncongenial contact. It is, therefore, highly desirable that 
our habits and manner should be such as not to conflict injuri- 
ously with the susceptibilities of our patients. Roughness never 
suffers by the contact of the smooth and polished; while refine- 
ment shrinks sensitively from whatever is harsh or coarse. It 
follows that, among the duties of the physician, is the cultivation 
of a polished manner, and the exercise of the amenities and 
courtesies of a gentleman on all occasions. 

Picture to yourselves the consequences which must often flow 
from the non-observance of this duty. Suppose a woman of 
native delicacy and becoming sensitiveness, brought up with the 
refined tastes and habits of the true lady, and altogether unac- 
customed to the coarse, harsh, and slovenly in dress and manner, 
to be attacked with an illness, which, while it may possibly be 
dangerous, nevertheless leaves unimpaired her powers of observa- 
tion, and sensibility to outward impressions. Suppose, also, 
that, from the necessities of the case, a practitioner is called in, 
previously unknown to the patient, and, as it happens, quite 
ignorant of the proprieties of cultivated society, or, if not igno- 
rant, despising them. He enters the sick chamber abruptly, 
perhaps carelessly dressed, it may be even in his shirt-sleeves if 
the weather is very hot, or in a coarse, shaggy overcoat, if it is 
cold or stormy. Not having taken the precaution to use the 
scraper or the door-mat, he leaves at every step a soiling track 
upon the fine carpet. Perhaps, before reaching the bed, he may 
squirt out a mouthful of tobacco-juice upon the floor, or make a 
not less disgusting deposit from his nasal or bronchial passages. 
His near approach discloses, to the delicate sense of the patient, 



CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 255 

that his person or breath is reeking with the odour of tobacco, 
onions, or bad whisky. He addresses her gruffly, seizes her 
wrist with a bearish gripe, makes farther investigations without 
delicacy, pronounces his decisions abruptly, and leaves the room 
with as little regard to propriety as he entered. Now, what do 
you suppose would be the effect on the patient ? Nauseated and 
faint with disgust, shocked by the rudeness, scarcely able to 
appreciate his questions, and quite unable to answer them 
efficiently, she presents to him an aspect wholly different from 
that proper to her disease, and very likely to mislead his judg- 
ment. However well informed he may be professionally, he 
would probably form false or imperfect views of the case, and 
consequently prescribe incorrectly or inadequately; while the 
patient herself, without confidence in the prescriber, would 
submit reluctantly, if at all, to the measures proposed. The 
result might be a serious aggravation of the danger, possibly a 
fatal issue of the disease, which a more judicious practitioner 
might have averted. 

It may be said that this is an extreme case. I most cheer- 
fully admit that it is so. I am happy to say that very few 
regular practitioners could be found capable of fulfilling all the 
conditions here imagined. But I appeal to your own observa- 
tion, whether the picture might not find its prototype in real 
life ; and, if drawn somewhat strongly, it may perhaps prove the 
more impressive. 

There are two kinds of politeness, both of which demand 
observance. One is conventional, based upon custom, and there- 
fore variable in different communities ; the other essential, spring- 
ing from the inherent principles of our nature, and unchangeable 
with time or place. The former consists in attention to modes 
of dress, address, movement, eating, drinking, and all the cere- 
monials of social intercourse. These, though in themselves of 
little importance, are connected with our well-being through 



256 CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 

their influence on opinion. A neglect of them occasions disap- 
proval, ridicule, disgust, even reprobation and avoidance, and 
often interferes with social acceptance and professional success 
much more than moral obliquity, when covered over with a 
decent veil of propriety. I do not say that this is right ; but so 
it is, so it always has been, and so it will continue to be until 
the millennium. Few men can withstand the neglects, rebukes, 
and indignities which follow a non-observance of the ordinary 
ceremonials of civilized society; and nothing but well-known 
conscientious scruples, an established character for eccentricity, 
or extraordinary eminence in rank, wealth, or talent, will be 
admitted even as a palliative. 

To over-act in all these matters, though less offensive, exposes 
equally to ridicule. To dress and act like a fop, or show in any 
other way that the mind is wholly absorbed in these external 
and formal observances, is supposed to indicate either native 
deficiency of mind, or want of substantial attainment ; and, unless 
counteracted by palpable evidence to the contrary, will inevitably 
lead to distrust and neglect in all relations of business. 

For the medical practitioner it is necessary to avoid both these 
extremes. The great rule for him, upon all the points referred 
to, is so to appear and act as not to attract peculiar attention, or 
excite remark. Many a man of talents and high attainments 
has thrown away his chances of success in life by a neglect of 
this rule, and wonders how it has happened that he has been 
surpassed in the race by persons, whom be well knows to be 
less qualified substantially than himself. 

The second kind of politeness, the essential or native, which 
is only the outward expression of kind and benevolent feeling, 
goodness of heart, sound principles, and noble sentiments, though 
perhaps less indispensable to success in a business point of view, 
contributes greatly to social acceptance, and the attainment of 
influence through the affection and esteem of the community. 



CHARACTER AND OBJECTS OP THE MEDICAL PROFESSION. 257 

The amenities of a true gentleman are a coin which is every- 
where current, and secures for its dispenser the favour of men 
of all modes of thinking, and all grades of life, because addressed 
to feelings and principles characteristic of human nature itself. 
Christianity is in this respect the very highest gentility ; because 
its tendencies are altogether to inspire the sentiments which 
lead to courtesy of act and manner ; the postponement of one's 
own wants or pleasure to those of others, the scrupulous avoid- 
ance of unnecessary offence, a kindly yet not intrusive interest 
in the happiness of all, and universal gentleness in deportment, 
and beneficence in deed. High and sanctimonious profession, 
without these fruits of the true Christian spirit, may always be 
suspected. 

Men of the world, observing the influence of these amenities 
of intercourse, whether based upon religious sentiments, or the 
result of a well-balanced nature duly cultivated, though unable 
or unwilling to attain to the inner reality, adopt its external 
representative, and thus present to the world the appearances 
of a gentleman. These appearances become at length the stand- 
ard ; and he who observes them carefully, whatever may be his 
genuine character, takes the social position, and exercises the 
social influence belonging to the reality ; because mankind can 
judge of the heart only by external signs. Now, this outward 
garment of politeness, though thrown over an evil nature, is 
certainly preferable in social intercourse to its opposite rudeness, 
and will in a much higher degree promote one's worldly interest. 
It is a desirable acquisition for all, and for none more than for 
the members of our profession. You will, therefore, cultivate 
with great care all the courtesies which are considered as char- 
acteristic of the gentleman. Remember, however, that, beyond 
comparison, the most successful mode of culture is to develope 
and cherish the inner virtues from which they naturally spring. 
An evil heart will occasionally, in spite of the most careful 

17 



258 CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 

watchfulness, make itself visible through the garb of refined and 
polished manner ; and no one can always be certain of himself, 
who wants the perennial source within, from which the outward 
graces of character spontaneously issue. 

4. There is one other point connected with the requirements 
of the medical profession, which cannot be omitted, without 
leaving incomplete the view I have attempted to sketch for you. 
Ours is a pursuit in which the inmost secrets of individuals and 
families, not unfrequently involving character, and sometimes 
even life, are necessarily unveiled to us ; being betrayed by the 
very nature of the disease, or entrusted to us in our professional 
capacity. All such secrets the physician is bound to keep reli- 
giously; and no promise, however solemn, no oath, however 
awful its sanctions, can add one iota to the obligation, under 
which he is placed by the very nature of his calling. To his 
most intimate friend, even to the wife of his bosom, his lips must 
be sealed forever, so long as the slightest injury might, by any 
possibility, result from a disclosure. Though the person con- 
cerned might subsequently become an enemy, the knowledge 
acquired in professional attendance can rarely be used as a 
weapon even of defence. The law alone presents a higher obli- 
gation to his conscience ; and I can conceive of cases in which 
even this would not excuse a violation of professional confidence. 
It is, on the whole, a good rule for the medical practitioner, to 
say as little as possible, in ordinary social intercourse, of what 
may come under his notice in his rounds of attendance, even 
though there may be nothing which could be looked on as a 
secret. To have the reputation of a gossiping doctor is any- 
thing but creditable. To betray confidence is in the highest 
degree base and wicked, if done with an evil purpose ; and is 
wholly inexcusable, if done carelessly or inadvertently. This 
principle you should fix deeply in your consciences, even at the 
threshold of your professional career, and make it as it were a 



CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 259 

part of your very nature, so that a violation of it should be as 
impossible as a disregard of his promise, or a palpable falsehood 
is to an honourable man. 

In closing the address, I would ask of you to contemplate the 
general character of the profession, as I haye endeavoured to 
present it, and to open your hearts to the feelings it is calcu- 
lated to inspire. Consider its great and noble aims, the ability 
and knowledge requisite for its due exercise, the graces of de- 
portment and character, and the high principles of honour 
demanded of all its true votaries. In a well-constituted mind, 
it is impossible that feelings of profound esteem and warm at- 
tachment should not spring up, and expand into an absorbing 
sentiment, under such contemplation. The genuine professional 
spirit is thus generated, which, once possessed, you will find of 
inestimable value. It will tend to elevate you above all that is 
base, grovelling, or purely selfish ; will serve, even in your state 
of pupilage, to stimulate to honourable exertion, and guard 
against discreditable acts of all kinds ; and, in your future course 
will, next to a sense of religious obligation, or in connection with 
it, be your surest guide to honour and usefulness in life, and 
happiness at its close. 



LECTURE IV. 



DELIYERED OCTOBER 13th, 1S59. 



Scope of the Practice of Medicine. 

Gentlemen : — 

You know that my office in this school is to teach the theory 
and practice of medicine ; in other words, the knowledge and 
treatment of disease. In order that you may enter on this study 
with a proper spirit, that your efforts may be duly directed in 
the course of it, and that, when it is concluded, you may be 
prepared to apply your knowledge with the best practical effect, 
it is advisable that, at the very outset, you should be made ac- 
quainted, as far as may be, with its true nature and objects. 
To this purpose the few remarks which follow will be applied. 
My wish is to make them as precise and intelligible as possible, 
without ornament, or any attempt at display. Whatever im- 
pressiveness they may have must depend upon their truth. 

1. In the first place, I would inculcate upon you that the 
theory and practice of medicine is not a particular system; not 
a set of rules or precepts, based on some one dogma with pre- 
tensions to universal application. This narrow view of it is 
one which irregular practitioners of all descriptions endeavour 
to impress on the public mind, in order to further their own 
ends. Regular medicine, they say, is an old system, worn out, 
senile, effete ; while their own is new, with the vigour of full 
maturity, on a level with the times, corresponding with the ad- 
(260) 



SCOPE OP THE PRACTICE OF MEDICINE. 261 

vanced knowledge and higher intellect of the age. Thus they 
endeavour to dignify their position by putting themselves on 
the same foundation with us, and then claim superiority upon 
the score of progress and reform; the two great watch-words 
of the times, as often the cover of ignorant pretension and selfish 
cunning, as the signals of forethought and philanthropy. 

I would adduce a single instance. The homceopathists, after 
the example of their founder Hahnemann, while they put forth 
their own fundamental principle, that disease is to be cured by 
medicines having an effect similar to the disease itself — an ab- 
surdity drawn from the musty records of our own science, 
similia similibus curantur— maintain that the regular practi- 
tioners act upon the opposite rule, that the proper remedies for 
a disease are those which produce an opposite or dissimilar 
effect, and hence designate us by the nickname of allopathists. 
Thus, they would make the question before the public, not be- 
tween regular and irregular medicine, but between homoeopathy 
and allopathy; the one a new system for which they claim the 
support of a transcendental reason, and a confirming experience ; 
the other an old system, not entirely worthless, adapted to the 
unenlightened times in which it originated, but quite unequal 
to the wisdom of the present age, and not to be compared with 
theirs. It is easily to be seen that a question of this kind, be- 
fore the altogether ignorant and often very conceited tribunal of 
individual opinion, must frequently be decided in favour of him 
who can talk most plausibly, utter falsehoods most glibly, and 
bow most profoundly before the silly vanity of the party ad- 
dressed. Is it surprising, therefore, that homeceopathy has dis- 
ciples and advocates in a community, quite ignorant of the subject 
discussed, and especially among the more amiable and credulous 
sex, who, being true themselves, can scarcely appreciate the 
falsehood of those who stoop to flatter either their personal or 
intellectual perfections ? 



262 SCOPE OF THE PRACTICE OF MEDICINE. 

Even medical men have ia many instances inconsiderately 
given in to this error, and strengthened the cause of their ad- 
versaries by recognizing the title of allopathy, and with it of 
: urse the principle upon which it was applied. I would guard 
you against a similar mistake. Not only scrupulously avoid the 
use of the term as applied to your profession, bot disclaim it 
altogether when applied by others. Let it be seen that the 
nickname is offensive, and that its purposed repetition would be 
incompatible with the courtesy of refined social intercourse. 

TVe are not allopathists. We do not base onr plans of treat- 
ment on the asserted dogma, nor*, indeed, on any other one the- 
ory or principle. Medicine, as a science, consists of all the 
knowledge in reference to disease which has been gathered from 
past ages, or accumulated in our own times. As a practice, it 
embraces all the means, from whatever source derived, which 
can be made available in the cure, alleviation, or prevention of 
y sease. Tr.e physician is confined within no limits except those 
of truth and honour. He seeks for knowledge wherever it can 
be found. He would even receive it from the hands of the 
quack ; for it has that excellent quality that it cannot be defiled 
by the filth around it. He does not reject the systems or prac- 
tices of the irregular practitioners, because they may be in sup- 
posed opposition to his own interests ; but because, enlightened 
as he is upon the subject of our bodily constitution, he knows 
that they are untrue ; that they are visionary illusions of igno- 
rance or fanaticism, or unprincipled assumptions of mere char- 
latanism. Hence the pity or scorn with which he regards their 
professors ; pity for the few who are honest but deluded; scorn 
for the t :eater number who know what they are about, and seek 
a vile livelihood oat of the ignorance, credulity, or imbecility of 
the multitude. Especially does he regard with unmitigated dis- 
gust the dese: ers from his profession, who, having received 
light, and knowing as well as himsei: the wortt'essness and 



SCOPE OF THE PRACTICE OP MEDICINE. 263 

noxiousness of the different forms of quackery, nevertheless 
abandon the regular practice, because it has not satisfied their 
aims of self-interest or cupidity, and throw themselves into the 
current of some popular delusion, hoping that it may bear them 
on to fortune. These deserters, it must be acknowledged, are 
relatively very few; and it is a subject of honest self-congratu- 
lation to our profession, that, in the midst of an over-crowded 
competition, in the long struggles, the disappointed hopes, and 
the too often fruitless patience of the first years of practice, in 
the face too of the occasional gaudy and glaring successes of 
quackery, strutting and flaunting before the eyes of the aston- 
ished community, so small a number should be found willing to 
abandon their colours, or at least to go over to 'the enemy. 

I may presume, gentlemen, that you are now possessed of the 
real nature and scope of medical study ; that it is no one system, 
hypothesis, dogma or set of dogmas that you are to learn, but 
facts and philosophical deductions from them ; in other words, 
simply truth in its relation to human health, gathered from the 
observation of all time, garnered up and methodized for the most 
convenient acquisition by the learner, and destined to go on in 
the course of accumulation, simplification, and improved arrange- 
ment, until at length it shall embrace, within a scope not beyond 
human capacity, all that a wise Providence has ordained for ob- 
viating the miseries of disease. 

It must be clear to you that any one hypothesis, intended to 
explain everything, and be a sufficient guide to practice in all 
cases, must be a pure assumption, and necessarily false. At- 
tempts have repeatedly been made, in the history of our science, 
by highly imaginative and inventive minds, to fashion such hy- 
potheses ; and the medical world has been led astray by these 
false lights, to flounder in the slough of speculative error, and 
to reach again the fast ground of truth, only after long fruitless 
wandering, and wearisome struggles. A true theory can be 



264 SCOPE OF THE PRACTICE OF MEDICINE. 

formed only by deduction from facts. Now, facts enough have 
not been collected to serve as the basis of a universal theory in 
medicine. There are points in our physical constitution, of the 
nature of which we have not even a conception. We do not 
know what is life ; the very principle which governs all those 
operations of our system, by which it is distinguished from a 
mere physical machine. We have traced anatomy into its mi- 
croscopic elements of molecules, fibrils, cells ; but we are utterly 
ignorant of the force which creates these wonderful germs, and 
of the laws which direct their no less wonderful, I might say, 
their sublime developments. We have learned enough to teach 
us how vague, how utterly inane have been the profoundest 
speculations in our science, having any claim to universality : 
enough also to satisfy us that much, much more must be learned, 
before we can even begin to fashion such speculations hereafter, 
with the least hope of permanent acceptance. To succeed in 
such an attempt, in the present state of our knowledge, would 
require a direct admission into the counsels of Omniscience, an 
inspiration proceeding immediately from the fountain of creative 
wisdom ; and, even were a doctrine put forth under such super- 
natural influence, it would probably be rejected by us in our 
self-sufficient ignorance ; for it would necessarily be a mystery, 
unintelligible because we do not understand the facts upon which 
it would rest, and should, in all probability, be ignorant of the 
very meaning of the terms in which it would be expressed. 

Here, then, is a touchstone by which we may, to a certain ex- 
tent, estimate the truth of any asserted medical dogma. Does 
it claim to be universal ? If so, it must be untrue. We may 
pronounce as positively on this point, as the physical philoso- 
pher pronounces on the point of perpetual motion. Such theo- 
ries, therefore, as homoeopathy, though a thousand times more 
plausible than that miserable absurdity, must be rejected ; such 
universal remedies as the water-cure, and all other panaceas, 



SCOPE OP THE PRACTICE OP MEDICINE. 265 

must, from their very universality, be purely empirical ; that is, 
they must be destitute of any basis in abstract reason, and de- 
pend for their asserted value solely on experience. 

Do not understand me as being opposed to all theory in medi- 
cine. To a certain extent, this is essential for the convenient 
arrangement and recollection of facts. These accumulate as the 
result of observation and research, until they at length become 
so numerous as, in their isolated state, to be quite unmanagea- 
ble for any useful purpose. Upon examination, natural relations 
are found to exist among them ; these relations appear to de- 
pend on some principle common to the several series in which 
they are observed ; and the principles thus deduced serve, not 
only as handles to the memory, by which it may hold on to the 
several bundles of facts, but also as clues to further research. 
The science of medicine is full of such principles, and could 
scarcely exist as a science without them. It does not neces- 
sarily follow that they are all true. They may be considered 
so, if found applicable to every fact professed to be embraced by 
them. We may, for convenience sake, admit their truth pro- 
visionally, even though there may be some apparent exceptions; 
for it may be hoped that these exceptions will, in the end, prove 
to have been merely apparent. They must be abandoned when 
any fact is discovered, and established beyond doubt, which is 
quite incompatible with them. But, even though rejected with 
the advance of knowledge, they have served a useful purpose, 
and tended on the whole to the improvement of science. 

What I especially wish to guard you against is the accept- 
ance of any one universal, and of course exclusive hypothesis, 
which in the nature of things cannot be true, unless a direct 
revelation from Omniscience, and which, if untrue, and yet 
adopted and acted on, must lead to inexpressible evil. Even in 
relation to the partial principles referred to, you should be on 
your guard not to let them sway you too exclusively, so as to 



266 SCOPE OF THE PRACTICE OF MEDICINE. 

close your eyes and your will against truths that may be hostile 
or even fatal to them. 

With the reiteration then of the statement, that the science of 
medicine, as it now exists, is not one exclusive system, and can- 
not therefore be in opposition to, or in fact have any relation 
with, any such asserted system ; and with the repetition of the 
advice, that you should on all occasions disclaim and reject this 
false position in which the enemies of regular medicine, whether 
original or renegade, would desire to place you, I leave this 
branch of the subject, and proceed to another point, in relation 
to your future profession, scarcely less important than the one 
discussed. 

2. The point referred to is, that the science of medicine is yet 
imperfect, and its powers limited. The practical inferences are, 
that you are not to expect too much from it, and should be spe- 
cially careful not to claim more credit than may be justly due to 
you in its exercise. 

Some diseases are in the present state of our knowledge quite 
incurable. Many run a certain course which medicine may in 
some degree regulate, bat cannot interrupt, unless by the de- 
struction or at the great risk of life. Others, again, may be 
influenced both in degree and duration, and may often be cut 
short with advantage. 

Now, it must be quite obvious to you that any one general 
plan of management cannot be adapted to these several varieties. 
The incurable you must be content to palliate, until some new 
discovery shall remove them from that sad category. Those of 
definite course and duration you must manage cautiously, aim- 
ing not at their immediate cure, but simply to prevent mischief 
in their progress, so that they may eventuate favourably when 
the period for their termination shall come. Unhappily, they 
will in many instances prove too strong for you, even with the 
appliance of your best skill ; but very often also you will, by 



SCOPE OP THE PRACTICE OF MEDICINE. 267 

good management, conduct to a safe issue cases which might 
have proved fatal without you. In reference to the third set of 
diseases, those, namely, without fixed duration or end, you will 
be determined in your course by the degree of apparent danger. 
Yery often, I might say in the vast majority of cases, they will 
terminate favourably in their own natural course, without any 
interference, and not unfrequently in spite of very improper and 
even injurious interference. Here it would be the height of folly 
to medicate vigorously ; as it would be the height of impudence 
or of ignorance to claim the merit of success from measures, 
which could have had no other effect than to incommode the 
patient, protract the disease, or endanger the result ; or, at the 
very best, to hasten a cure at the hazard of th.e patient, which 
would have occurred without any risk at a somewhat later 
period. It is only where danger, or suffering, or great incon- 
venience may be obviated, that vigorous treatment is admissible 
in such affections ; and, as occasions of this kind are not un- 
frequently presented, the physician must be prepared, with all 
his habitual caution, to act when requisite with great prompti- 
tude and energy. 

From this brief sketch you will at once perceive how utterly 
impossible it must be for an uninformed man to treat disease pro- 
perly, and what an awful responsibility they assume who run 
headlong into practice, with very imperfect preparation, or with 
no preparation whatever. 

I have said that you are not to expect too much from medicine. 
The young practitioner is peculiarly liable to error in this respect. 
He is apt to have great confidence in therapeutics, and conse- 
quently to wield its resources with an unsparing hand. Ex- 
perience in time generally convinces him of his mistake, and 
then he is in danger of running into the opposite' and equally 
incorrect extreme of skepticism. It is certainly best to start 
with correct views on this point. 



268 SCOPE OP THE PRACTICE OP MEDICINE. 

We have had examples of both of these extremes in the prac- 
tice respectively of the old Eaglish and French physicians. The 
former, who were copied by the Americans, were in the habit of 
using medicines in great excess. The ideas of disease and of 
drugs were inseparably associated in their minds ; the dosing 
of a patient was considered to be the main business of the phy- 
sician ; and no matter what the nature of the complaint, whether 
mild or severe, curable or incurable, self-terminating or otherwise, 
it would have been deemed unpardonable to let a case end either 
in recovery or death, without its full share of medication. Of 
course, I am speaking only in general terms. There were always 
individual practitioners who had escaped the trammels of pre- 
judice, and allowed themselves to be guided by the lights of 
reason and a well-considered experience. But of the general 
truth of the statement there can be no doubt. 

The source of this over-practice may be traced in part to the 
peculiar state of the profession in England. As before observed, 
the natural tendency of the young practitioner is to this extreme ; 
and the same may be said of the youthful period of the profession. 
But there were causes of a special character acting among our 
English predecessors. The practice was divided between two 
classes of medical men, the physicians and the apothecaries. 
The former only prescribed, and, having no legal claim for re- 
muneration, received an honorary fee at each visit. The latter 
both prescribed and furnished medicine, and, being protected by 
the law in their claims for compensation, so far as the medicines 
were concerned, though not for their advice, were paid not at the 
time of the visit, but subsequently, upon rendering their account, 
as is the case among ourselves. But, being allowed to charge 
only for the medicines supplied, they were irresistibly tempted, 
in order to swell their income, not only to affix an extravagant 
price to their medicines, but also to prescribe them extrava- 
gantly, and not altogether in reference to the wants of the case. 



SCOPE OP THE PRACTICE OP MEDICINE. 269 

Our views of right are notoriously affected by our supposed in- 
terests ; and finding that excessive medication was essential to 
their livelihood, they very naturally came to deem it essential 
also to the patient ; and this habit of prescribing was accord- 
ingly established among them. But it may be asked, how did 
these circumstances affect the class of physicians? Upon the 
same principle exactly. The apothecaries were those in general 
first called in, and might be considered as the regular family 
attendants. The aid of the physician was sought in consulta- 
tion, when the case became serious. Now, the apothecary could 
very often determine what physician should be sent for, and thus 
had it in his power greatly to promote the success of those whom 
he might be disposed to favour. The physicran could not be 
ungrateful. It would be unfair in him to lessen the profits of his 
benefactor; and he also, in the regular course of things, came to 
see the importance of a multiplicity of medicines, and of a free 
use of those selected. As our medical knowledge and habits of 
practice, in this country, were derived mainly from English books 
and English tuition or example, wc also fell into this vicious 
system of excessive medication, though never hampered by the 
same absurd classification of the profession as that which pre- 
vailed in Great Britain. 

But a new era arose with us, beginning with the teachings of 
Rush, which had a great tendency to the simplification of medi- 
cines, and much promoted by the direction of opinion towards 
the French views of medicine, when the pathological doctrines 
of Broussais were propagated among us. To this medical re- 
former, though I was never one of his disciples, and though his 
peculiar views have at present few or no advocates, we are, I 
think, mainly indebted for the great change of sentiment, on the 
point in question, which has been going on during the last thirty or 
forty years. We must admit also that the practice of the homceo- 
pathists has contributed to the same end, by demonstrating how 



270 scope or the practice of medicine. 

much nature can accomplish when wholly unassisted : for genu- 
ine homoeopathy, as you know, with all its wordy pretensions, is 
nothing more nor less than a skilfully contrived plan of doing 
nothing: I say skilfully contived ; because it has certainly suc- 
ceeded in imposing itself on great multitudes for an efficient 
agency, and thus niching from nature a credit to which it has 
no claim whatever. This is one only out of the innumerable 
instances in which, by the orderings of an all-wise Providence. 
good is deduced from evil. It is, indeed, a most happy circum- 
stance in the constitution of the universe, that wickedness in 
every shape leads to some ultimate good; and that while, in the 
little circle of their experience, the servants of his Satanic majesty 
seem to be working only in the cause of their master, there is an 
overruling intelligence, which is ever intertwining their bad 
deeds into that eternal bond, which connects all things in one 
great system of glory to God and good-will to man. 

You are not. then, to expect too much from medicine. You 
will make it a special subject of investigation, how far our 
present lights enable us to proceed with sure stops into the 
wilderness of therapeutics: you may justly and even laudably 
endeavour by your own efforts to widen this circle of illumina- 
tion ; but. having gone thus far. stop; venture not unguardedly 
into the darkness : rush not headlong into the unexplored intri- 
cacies ; for the inevitable consequence will be that you will go 
astray, and may drag with you the happiness and li^es of those 
who may have put their trust in your skill and prudence. 

There was another practical point connected with the imper- 
fection of our science to which I alluded, and to which I would 
more particularly invite your attention ; the propriety, namely, 
on the part of the physician, of claiming no more than his due 
in estimating the results of treatment. In the vast majority of 
cases that will come under your care, it will be to nature and 
not to vourselves that the cure will be justlv ascribable. You 



SCOPE OF THE PRACTICE OF MEDICINE. 271 

may diminish suffering in these cases, perhaps not unfrequently 
shorten their duration ; but they would get well without you. 
Now, it would be stooping to the level of the quack, at least in 
one of the most characteristic of his habitual proceedings, to take 
to yourselves the whole merit here. If done ignorantly, it would 
be a strong proof of defective knowledge of disease, and of un- 
fitness for its management; if knowingly, and with the object of 
producing a favourable impression of your own skill, it would be 
dishonourable if not positively dishonest, and quite incompatible 
with the character of a high-minded man. Two great evils flow 
from this bad habit, one relating to the individual himself, the 
other to the profession and the public. The practitioner who 
sees in every recovery a cure effected by his skill, is apt to 
acquire an overweening confidence in his own powers, and to 
neglect utterly those means of self-improvement, which a be- 
coming modesty would lead him to seek for, and to employ dili- 
gently when within his reach. He thus remains ignorant, and 
is apt to become self-sufficient, and sometimes even ludicrously 
pompous in the eyes of better informed men. 

To the interests of the profession and the public the conse- 
quences are still more serious. If in all cases of recovery under 
medical treatment, the people are taught that a cure has been 
effected by the physician, they will naturally infer that diseases 
are never self-terminable, that when they end well the result 
must be ascribed to the means used, and consequently that a 
favourable issue is a proof of the efficiency of those means in 
every instance. You can readily perceive the evil that must 
ensue. It often happens that, in the absence of regular profes- 
sional aid, some supposed remedy is administered, perhaps harm- 
less, perhaps noxious, but at all events wholly inapplicable to 
the case, which nevertheless ends in recovery. The experiment 
is repeated in other cases with the same result. Now it will be 
inferred by the experimenter that the remedy is really efficacious, 



272 SCOPE OP THE PRACTICE OP MEDICINE. 

and, relying upon his supposed experience, he will be induced 
to administer it in all similar cases, with the effect probably in 
some of aggravating the disease, in some possibly of rendering 
it fatal, either by a direct injurious impression, or by the exclu- 
sion of positively curative methods. If the physician has set 
the example of claiming what he does not merit, and taken no 
pains to enlighten the public mind on this point, the result will 
be inevitable. Ignorant people will acquire confidence in their 
own power, or that of others equally ignorant, in the treatment 
of disease. All sorts of inert or inappropriate medicaments will 
get into vogue as popular remedies. The claims of irregular 
practitioners will be admitted, and quackery in all its forms will 
obtain more or less of the public confidence. This is, indeed, 
the great support of irregular medicine. Patients get well under 
the nothings of homoeopathy. These nothings are much more 
acceptable to the delicate or pampered taste than the nauseous- 
ness of positive remedies. The people are taught by their phy- 
sicians that a recovery is a cure. The recoveries under the 
homceopathist are therefore cures ; and, as he offends the sensi- 
bilities of the palate and stomach less than the regular prac- 
titioner, he is preferred to the latter by the squeamish, who are 
apt to be found among the most cultivated, and especially in the 
softer, and, in this respect, more influential sex. For those who 
cannot have faith in the power of infinite littleness, whose coarse 
and homely judgments cannot recognize the transcendental effi- 
cacy, evolved by a certain number of shakes made in a certain 
way ; for such as these there is the more substantial treatment 
of vulgar quackery ; and the countless multitude of panaceas — 
the pills, the powders, the syrups, proclaimed everywhere as 
infallible by their shameless advocates, all positive, and conse- 
quently all capable of great mischief — become the false lights, 
which too often lead the ignorant into morasses, from which they 
may or may not flounder into health. 



SCOPE OP THE PRACTICE OF MEDICINE. 273 

The physician, then, who demands in all instances of favour- 
able result the credit of a cure, is playing directly into the hands 
of the irregulars. If his recoveries are necessarily cures, so also 
are those of the quack. He cannot escape this dilemma. He 
may assert that a larger ratio of recoveries takes place under his 
management ; but his opponent will assert the same, and with 
greater effect, just in proportion as he is more unscrupulous. 
Accurate statistics, in such matters, can scarcely be brought 
to bear on the public faith ; confident assertion and reckless 
falsification will be most apt to carry the day; and I need 
not tell you which class can wield these instruments most 
effectively. 

But the regular practitioner may object that, if we teach the 
public how little we really do, and how much is done by nature, 
they will be apt to desert us entirely, and either trust to her 
cheap aid, or have recourse to the more highly professing em- 
pirics. Supposing this to be. true, is it an argument for dis- 
honourable proceedings on our part ? Are we, professing to be 
honourable and high-minded men, to cheat the public into our 
support? and should we not by such conduct countenance 
quackery in all its forms, and every other species of humbug ? 
Better far abandon our profession, and seek a livelihood in some 
honest calling, however humble. 

But this is a needless fear. Providence has not so arranged 
affairs in this world, that, in one of the noblest and most en- 
nobling pursuits in which man can engage, falsehood should be 
essential to success. At the same time that the people are 
taught truly in relation to the spontaneous curability of most 
diseases, they will also be taught that many cases can end favour- 
ably only under appropriate management; that many others, if 
left to themselves, though they may not prove fatal, may without 
proper attention degenerate into long-continued and troublesome 

18 



274. SCOPE OF THE PRACTICE OF MEDICINE. 

chronic affections ; and that even of those to the cure of which 
nature may be adequate, almost all may be rendered by the 
skilful physician less painful, and the greater number materially 
shortened. These advantages can be appreciated by the most 
obtuse judgment ; and the regular physician will be the more 
readily believed in all that he claims, when it is known that, in 
what he disclaims, he tells the truth to his own apparent loss. 
Besides, the sick are seldom able to appreciate their own real 
condition ; and, even in those instances where little is required, 
fearing the worst, they will be apt to apply to the physician for 
his counsel, especially if they have learned to trust him, and to 
believe that he will not unnecessarily burden them either with 
medicine or attendance. 

3. But, while I would guard you against an overweening con- 
fidence in medicine, I would equally warn you against that sense- 
less skepticism, which is but the too natural result, in a badly 
balanced mind, of reaction from an overstrained faith. Bigotry, 
in our profession as in religion, when it yields before the light 
of reason, is too apt to seek refuge in absolute infidelity. An- 
other source of this want of confidence in therapeutics is a too 
exclusive devotion to medicine as a science, to the study of the 
structure and functions of the system both in health and disease, 
rather than to the means of restoring that structure and those 
functions to their normal state when deranged. An exclusive 
addiction to any one pursuit is apt to narrow the mind against 
the reception of knowledge from other sources. Hence, the pro- 
found mathematician is often nothing else than a mathematician, 
the linguist than a linguist ; and it is notorious how often the 
poet, who cultivates only the imagination and the feelings, and 
lives in the unreal, is wholly unfit for the struggles of this sub- 
lunary world. So is it with the medical student who surrenders 
himself, with a too partial zeal, to the studies of physiology and 
pathology. He neglects of course the practical and most import- 



SCOPE OF THE PRACTICE OF MEDICINE. 275 

ant branch of his subject, and comes at length to doubt or dis- 
believe in the existence of remedial influences, at least of such 
as art can wield. Hence probably the medical skepticism of 
many of the profound pathologists of Europe, who study diseases 
as the botanist studies vegetable nature, and the geologist the 
structure of the globe, simply to learn what they are, not with 
a view to alter or amend them ; science being with them the 
end instead of the means. Now, admiration of these great 
men, on the part of the pupil, not unfrequently extends to 
their errors and deficiencies as well as their excellencies ; and 
hence another source, in unfortunate example, of the skepticism 
referred to. 

You may possibly be sufficiently protected against this serious 
evil by a knowledge of Its existence and ordinary sources, so 
that you may know whereto be on the watch. But it is desira- 
ble that your assurance of the efficacy of medicine, of its fre- 
quently indispensable instrumentality in the preservation of life, 
should be based on positive and conclusive evidence. Of this 
nature is the testimony of the best informed, the most experi- 
enced, and the most honourable, not only among the living, but 
also in the long series of those, who have left behind their re- 
corded experience for the benefit of mankind. This testimony, 
while it admits the incurability of some diseases, and the occa- 
sional insufficiency of all known measures to the cure of others, 
is united upon the point of the great utility of therapeutics prop- 
erly applied. These men cannot all have wished to deceive ; it 
is scarcely possible that they can all have deceived themselves. 
Their combined evidence is, therefore, to a certain extent, irre- 
sistible to a sound and unprejudiced judgment. Give due 
weight to their assurances, and you will be spared the skep- 
ticism which might possibly result from a one-sided direction of 
your confidence, and of your studies. 

But your rational convictions may be strengthened by personal 



276 SCOPE OF THE PRACTICE OF MEDICINE. 

observation. Watch the bedside of patients in private and hos- 
pital practice ; observe the progress of various chronic diseases 
before and after the commencement of a course of judicious treat- 
ment ; compare the result with that of other similar cases aban- 
doned exclusively to nature; do all this in the most cautious 
manner, and with the most impartial spirit ; and, depend upon 
it, you will come out warm advocates for the efficiency of thera- 
peutics. 

Besides, is it at all consistent with the general course of Prov- 
idence, to suppose that so great an evil as disease should have 
been allowed to exist, without some remedy at the command of 
the afflicted? In physical nature, do we not observe constant 
efforts for the repair of injury ? Floods devastate the earth. 
But notice the deposit upon their shores gradually rising, and 
rising, and at length confining them within due limits, and ren- 
dering them essential agents of good. Volcanoes pour forth 
their overwhelming torrents of lava, which hardens as it cools, 
and buries whole regions in a rocky tomb. But the winds and 
the rains soften the indurated surface, and clothe it in fine with 
a fruitful soil. The tempest, the earthquake, or other great 
physical agency, rends mountains asunder : and huge rocky 
masses topple from their heights, and spread ruin over the 
fruitful valleys at their base. But here again the flinty sur- 
face undergoes a gradual disintegration ; the sharp angles are 
rounded off, the rough cavities are filled up ; and what was a 
wide scene of desolation becomes beautiful with swelling heights, 
and soft declivities, and meandering streams, smiling with ver- 
dure and with flowers. 

So also is it in animated nature. Look at the broken or 
wounded plant, and observe by what a beautiful process the 
injury is repaired, and even its vestiges ultimately effaced. 
Those of you who have paid the least attention to physiology 
know well, with what resources the animal system has been 



SCOPE OF THE PRACTICE OF MEDICINE. 277 

provided for the repair of injuries, and the restoration of lost 
parts. 

In the higher moral world the analogy with the physical is in 
this respect complete. The history of nations and of individuals 
is often but a series of successful efforts to avoid and repair 
injury. From the cradle to the grave we are called on to mourn 
for losses which are the inevitable lot of humanity ; and, but for 
the happy remedial influences which nature in various ways 
brings to bear upon us, our experience in this world would be 
too often of almost unmitigated suffering. What is the great 
scheme of Christianity itself, but a glorious remedy provided 
by the all-good and all-merciful, to save a sinful world ? 

Is it possible, then, that Providence should have placed man in 
the midst of noxious influences, have given him an inquiring 
spirit to search, an intelligence to apply, and an inborn irre- 
sistible hope to use efficiently, means for counteracting these 
influences, and have done all this with no other purpose than 
to deceive and disappoint? To me the notion is inconceivable; 
altogether inconsistent with our convictions of the joint power 
and goodness of the Creator. 

There are remedies for our diseases ; for all of them, I believe, 
not essentially fatal by an interference already exercised with the 
processes of life. Many of these remedies have been discovered ; 
many yet remain concealed to reward future research. Compare 
the past with the present, and from this comparison infer how 
much is to be hoped for the future. To refer simply to two in- 
stances, the one prophylactic, the other remedial ; I would call 
to your attention the preventive power of vaccination over small- 
pox, and the curative influence of Peruvian bark over miasmatic 
diseases. These two scourges, which formerly devastated the 
globe, are now brought into comparative subjection to the power 
of man. Thus will it probably some time be with diseases 
still essentially incurable, or extensively destructive by their 



2TS scope or the practice of medicine. 

violence. Cancer and consumption, yellow fever and cholera, 
are yet, it may be hoped, to come within the certain control 
of medicine. 

Guard, therefore, your faith in the efficiency of the profession 
you are about to enter. But you hare another office to perform. 
It will become your duty to impart faith also to the non-profes- 
sional community, and to cherish and preserve it when already 
existing. For this purpose it will be necessary for you to em- 
ploy all the resources of your judgment and reason ; but beyond 
comparison the most efficient agency will be that of your ex- 
ample. You must not only by your conduct show that you have 
faith yourselves, but must labour zealously for those qualifica- 
tions, by which you will be able to set forth in practice the prin- 
ciples you inculcate by precept. Make yourselves conversant 
with all that is good in medicine, and you will through life ex- 
hibit, to the public, in your persons and conduct, an ever-present 
and irrefragable proof of the real value of our science. When 
the whole profession shall have elevated itself to a high standard 
of character and attainment, it may bid defiance alike to the open 
assaults and covert stratagems of its enemies. Ignorance, super- 
stition, and weak-mindedness will probably, until the millennium 
shall come, afford a refuge for the frauds of charlatanism in ours 
as in all other pursuits ; but we can afford to be content with 
this when we shall have on our side the intelligence and worth 
of the community; for these will, as a general rule, govern even 
the uninformed masses ; and it will be only in the darkest quar- 
ters, and the most remote haunts of the moral world, that 
quackeiy will be able to show its face. 

I have at present but one farther remark to make. All that I 
have said must have been uttered to little purpose, if it do not 
tend to confirm and stimulate you in all proper effort in the 
honourable course which you have entered. Keep ever before 
you the great ends of your studies, the incalculable importance 






SCOPE OF THE PRACTICE OF MEDICINE. 27 J 

of the duties which are to devolve upon you, and the awful 
responsibility connected with the discharge of those duties ; 
and you will spare no endeavours to avail yourselves to their 
full extent of the advantages now offered, so that, when you 
ultimately leave us, you may go forth accomplished physicians, 
prepared at once to encounter disease most successfully, and to 
offer before the public, in your lives and character, a convincing 
proof of the truth, the power for good, and the pure and lofty 
aims of your noble profession. 



TWO 

INTRODUCTORY LECTURES, 

GIVING THE KESULTS 

OF 

PROFESSIONAL OBSERVATIONS 
IN EUKOPE. 



LECTURES 



UPON 



THE MEDICAL PROFESSION IN EUROPE. 



Prefatory Remarks. 

The two following lectures were delivered as introductories, the first, 
in the year 1848, to the coarse of materia medica, the second, in 1853, 
to the course of the theory and practice of medicine, in the University 
of Pennsylvania. As my travels, during my first visit to Europe, were 
confined to Great Britain and Ireland, the first lecture refers exclu- 
sively to professional observations made in those islands. The visit 
made in the summer of 1853 extended also to the continent; and it is 
to the state of the profession in this portion of Europe that the second 
lecture is confined. In both, the statements made are extremely gen- 
eral ; as it was necessary to confine the matter within such limits as not 
to exceed the time usually appropriated to introductories. As regards 
Great Britain, some of the observations are no longer justly applicable, 
at least in their full extent ; as the state of the profession has within a 
few years undergone considerable change ; and a movement of reform 
has commenced, which will in all probability lead ultimately to the best 
results. Of these one of the most important is the consolidation of the 
three pharmacopoeias, those, namely, of London, Edinburgh, and Dub- 

(283) 



254 INTRODUCTORY LECTURES. 

lin, into one, which is to constitute the pharmaceutical code of the 
whole empire. The benefits of the uniformity thus introduced will be 
extended, in some degree, to this country, where British medical works 
are so much read, and where the confusion of British pharmac-7 lis 
sometimes been productive of considerable embarrassment. — Preface to 
the first edition. 



LECTURE I. 



DELIVERED OCTOBER 19th, 1848. 



The Medical Profession in Great Britain. 

It is a good general rule that an introductory lecture should 
have a close relation to the subject of study which it proposes 
to introduce. This rule I have generally observed in my pre- 
liminary addresses to the medical class. But the ways of man's 
conduct in life, like those for his feet, cannot always be rigidly 
straight. They must be accommodated in the one case to the 
irregularities of circumstance, as in the other to the inequalities 
of surface. My position at present is, I think, such as to re- 
quire of me a deviation from the ordinary course. Recently re- 
turned from travel in a foreign country, I may be reasonably ex- 
pected to impart to those whom it is my duty to instruct some 
of that knowledge, having reference to our common pursuit, 
which I may have gathered while absent. I know of no oppor- 
tunity better adapted to this purpose than that offered by the 
opening of a course of instruction, before the attention has yet 
been engaged in a regular series of observation and study, which 
it might be inconvenient to interrupt. You will, therefore, ex- 
cuse, perhaps you may even commend me, if, on the present 
occasion, omitting all mention of the materia medica, the teach- 
ing of which is my special function, I shall in its place introduce 

(285) 



286 THE MEDICAL PROFESSION IX GREAT BRITAIN. 

to you a subject from abroad, and one no less important than 
that of the state of the medical profession in the British Islands. 
This is so peculiar, so different from what prevails in the United 
States, that it cannot but be an object of interest to all among 
you who have an inquiring spirit ; and, considering the high 
civilization of that great country, the source of so much in every 
department of knowledge and art that we ourselves boast of, 
its arrangements in relation to a profession, so influential as 
that of medicine, must offer many valuable lessons, whether for 
imitation or for warning. 

The present organization of the medical profession in Great 
Britain, like her political constitution and common law, has been 
the gradual growth of her wants or necessities, without any 
preconcerted or consistent plan. Unfortunately, accidental in- 
fluences have been less successful in shaping institutions to the 
requirements of the case in this than in the other branches of 
public concernment ; probably because medical knowledge lies 
less within the scope of mere human reason, and demands more 
of slow, patient, and persevering research, than either the polit- 
ical or the legal. Place together a number of individuals of 
Anglo-Saxon origin, beyond the pale of established government 
or acknowledged law ; and, by the mere force of judgment, they 
will arrange themselves, almost as by a process of crystallization, 
into a regular and orderly community, with an organic constitu- 
tion, and a legal code, admirably adapted to their wants. But 
their medical system, unless under instructed professional over- 
sight, will scarcely rise above the empiricism of savage tribes ; 
being withdrawn from the control of reason, which is powerless 
when unsupported by facts, and given up to the caprices of the 
passions and imagination. It could not be expected, therefore, 
that a medical polity, which has grown out of mere accidental 
circumstances, should exhibit the same beautiful appropriateness 
to the condition of the communitv as mav characterize a simi- 



THE MEDICAL PROFESSION IN GREAT BRITAIN. 287 

larly originating system of law and government. It is univer- 
sally acknowledged in England that the organization of medicine 
in that country is defective ; and that, with a vast amount of in- 
dividual learning, skill, and devotedness, the general economy of 
the profession is not upon the same elevated level as the other 
great national interests. 

The medical and pharmaceutical professions in England em- 
brace four bodies of practitioners more or less distinct; the 
physicians, the surgeons, the apothecaries or general practi- 
tioners, and the chemists and druggists. Of these, the physi- 
cians practise medicine either exclusively, or in connection with 
obstetrics; the surgeons, strictly so called, are confined to opera- 
tions, and the treatment of affections generally denominated 
surgical ; the apothecaries combine the occupation of the pharma- 
ceutist, the physician, the obstetrician, and often of the surgeon, 
under the name of general practitioners ; and the chemists and 
druggists are restricted to pharmacy, in other words, are iden- 
tical with the apothecaries of this country. The last-mentioned 
body, as they practise neither medicine nor surgery, but confine 
themselves to the preparation and sale of drugs, cannot be con- 
sidered as belonging to the medical profession, and will, there- 
fore, be omitted in the remarks I am about to offer. I will simply 
observe of them, that they are relatively few; being confined for 
the most part to the larger towns, where they more than share 
their business with the apothecaries. They are, however, in- 
creasing in numbers, qualifications, and standing; and it is to 
be hoped that the time may come, when they may supersede 
their present rivals, and, compelling these into their medical 
functions exclusively, may get possession of the whole pharma- 
ceutical business, at least in all places where the population is 
sufficiently numerous to support an independent drug establish- 
ment. 

Of the three divisions which together constitute the great 



288 THE MEDICAL PROFESSION IN GREAT BRITAIN. 

medical body of the country, the physicians hold the highest 
rank ; though it cannot be denied that individual surgeons, by 
great talents and extraordinary success, have raised themselves 
to an eminence, not surpassed by any belonging to the more 
elevated branch of the profession. All are entitled to the name 
of physician who have graduated in a British or foreign univer- 
sity, or have become licentiates of the Royal College of Physi- 
cians of London. But there are certain regulations which limit 
the privilege of practising, at least the legal privilege, within 
narrower bounds. Thus, by the charter of the College of Physi- 
cians, that body has the power of preventing any one from prac- 
tising as a physician in London, or within seven miles of that 
city, who has not submitted to its examinations, and received 
its license; and may even enforce its privileges by fine and im- 
prisonment against those who reject its authority. All the 
regular London physicians are licentiates or fellows of the Col- 
lege ; the latter being the proper members of the body, and sup- 
plied by annual election from among the former. In relation to 
England and Wales beyond the limits just mentioned, I find it 
stated in the London and Provincial Medical Directory, that the 
only legal physicians are the licentiates and extra-licentiates of 
the College of Physicians, and the licentiates of the Universities 
of Oxford and Cambridge, to whom I presume should be added 
the graduates of the London LTniversity. Extra-licentiates are 
those permitted to practise only beyond the bounds of London 
and its vicinity. They undergo a different and probably less 
strict examination, and are required to pay less than one-half the 
diploma fees demanded of the licentiate, which are very large, 
being not much short of.three hundred dollars. But, though 
physicians, in the legal sense, may be thus limited, yet, accord- 
ing to the same book, the graduates of the Scotch and foreign 
universities have long been admitted by the College as licen- 
tiates ; so that the fact of graduation is in reality sufficient 



THE MEDICAL PROFESSION IN GREAT BRITAIN. 289 

authority to practise. When attending the late annual meeting 
of the Provincial Medical Association at Bath in England, I was 
accosted by a gentleman, who informed me that he had been one 
of my pupils, having attended lectures and graduated in the Uni- 
versity of Pennsylvania. He was an Englishman by birth, had 
for some reason which I did not learn chosen to obtain his medical 
education in the United States ; and, having received the honours 
of this school, had returned to his native country, and was now 
practising acceptably in one of its noblest cities, with no other 
authority than that of his American diploma. 

Having told you who the physicians of England are, I will 
next tell you what they do. It may seem strange to you that 
any information should be needed on this point;' and yet, if your 
notions were to be formed exclusively from what you are familiar 
with on this side of the Atlantic, you would have but an imper- 
fect conception of the professional habits of the English physician. 
Many of you, I dare say, fancy him to be a man out early and at 
home late ; riding from house to house on horseback, or in his 
one-horse vehicle ; at the beck and call of any one who may wish 
to see him whether by day or by night ; carrying his medicines 
along with him ; turning his hand to everything that may offer; 
at one time using the lancet, at another dressing a wound or an 
ulcer ; now perhaps extracting a tooth, and then superintending 
a labour ; and, at the end of the day's work, noting the results 
in his account-book, and congratulating himself that, at the ex- 
piration of the year, he may, by sending out bills, gather in 
enough to feed, clothe, and warm his family. A London or 
even provincial physician in England would smile at this notion 
of his day's work. The fact is that he rarely touches a medi- 
cine, eschews all surgical offices as beneath the dignity of his 
position, would probably as soon think of performing the part of 
an executioner as that of a bleeder or tooth-drawer, and yields 
up obstetrics with the greatest possible good-will to the general 

19 



'2'r'j rzz x:z:::.,i ~:-.:iz ?.= ::>" zy jEzai eettazn 

practitioner,, or to the few who make it a special dc y His 
business is purely to give advice and to prescribe. Tir metro- 
politan physician seldom leaves home before twelve or one 
o'clock, and then drives out with his chariot and pair ; and a 

zir -yiizzz- := a'.n:=: as neiessirv -n. aj-p-r- i&^-e as a i:.: :: a 
coat. Much of his most profitable business is at his own house, 
where he receives calls and gives advice after his breakfast hour ; 
the patients being admitted into a reception room, and one by 
one entering the sanctum in their turn. Tery many of his visits 
are in consultation with the general practitioner, who is usually 
\:\.-' :_ :.: :if : :i_:_~i itiie:: •::' :;:■=■ cis-ris-r ai.i in nild 
cases, and asks the aid of the physician when the symptoms be- 
come grave or obstinate. Not unfrequently he makes but one 
visit, waiting to be again summoned by the attending practitioner 
before repeating ix The ~ealthy only can afford the luxury of 
;:::::ur: :■:_ :". reg^'ar i::e::';.L:T :::n :ie Lj=:oiiz Ii :l:s 
country, the nearest approach to the ordinary practice of the 
English physician is that of a medical man of established repu- 
tation in one of our larger towns, who, wishing to limit his 
business, confines himself as much as possible to the giving of 
advice at home, and a consultation business abroad. But here 
:'_-:- . . .; '. : . v irises. I_r :a : I- :: ::_::-::::_ .':i:: ; eni'ire'y. 
With us, each piece of service is noted in the day-book, and a 
'-.:'.'. ir:_ ~..r~-.i. :':: :'--. ~i :'.e a: s:a:r I z-zf.: is. I: I:,.-:l :!.: 
service is paid for vrhri: received. We charge one or two dol- 
lars a visit, they expect a guinea or about five dollars. We have 
a legal claim for our fee, and often lose it. They have no legal 
claim for theirs, and are sure to get it. A physician in this 
country may, if fully occupied, in the most favourable situations, 
make eight or ten thousand dollars a year ; a London physician 
of high repute not unfrequently receives fh 
c:/:i~i'ri: :: ir-:^ :~ e^y-ive :i:~55,id i: 






T , U4 -. » _ ~— T . . w 



doubles that income. It is remarkable how our sensibilities ac- 



THE MEDICAL PROFESSION IN GREAT BRITAIN. 291 

commodate themselves to the peculiar circumstances of our 
position. The physician in England thinks that to send in a 
bill for attendance would level him with the mechanic, and looks 
with something like contempt on the practice. I confess that to 
hold out my hand for money, at each visit, would be repugnant 
to my sense of delicacy. I should feel as if I were reducing an 
honorary to a mercenary service. It seems to me that the prac- 
titioner, under such circumstances, though he may not abso- 
lutely repeat the servile formula — remember the physician — 
must have the words in his heart. 

The number of physicians is small, compared with that of the 
other classes of medical practitioners. They are almost all well- 
educated, many of them highly-educated men ; and, indeed, a 
good preliminary education is a necessary prerequisite to an ex- 
amination for the medical diploma, in all the English institutions 
which have the authority to grant it. They are also men gen- 
erally of cultivated manners, and have the moral tone as well as 
exterior polish which characterize the gentleman. Though inferior 
in rank to the higher aristocracy of the kingdom, they associate 
often upon equal terms with the best society ; and we occa- 
sionally see it announced in the Court Journal, that some physi- 
cian of eminence has been honoured with a seat at the queen's 
own table. They frequently have great influence with men in 
power, and with the community among whom they live. I re- 
peatedly met with physicians in the large provincial towns, who 
either were, at the time, or had been mayors of their respective 
corporations; and that position is even more honourable and 
influential in England than in this country. Their professional 
success is very precarious. It is, for the most part, after long 
waiting, and many of those delays which make the heart sick, 
that they become firmly established ; and the greater portion can 
expect little more than to make a respectable livelihood. Now 
and then, however, an encouraging instance of great success 



292 THE MEDICAL PROFESSION IN GREAT BRITAIN. 

occurs among them, leading to both fame and fortune, and serving 
as a beacon-light to ambitious aspirants. The system of high fees 
enables one who can obtain a large practice among the opulent 
to reap abundant emolument ; while it does not altogether pre- 
vent others from obtaining practice among the middling and 
poorer classes; for, though precluded by the general sentiment 
of his class, which has almost the force of law, from accepting 
less than a guinea for each visit, he may attain the same end by 
declining compensation for every second or every third visit, or 
even for two out of three visits, so as to bring the fees in fact 
nearly on a level with ours. 

From the physicians of England I personally met, whenever I 
came in contact with them, the utmost courtesy, and to many I 
am indebted for very kind attentions. To Drs. Pereira and 
Christison especially, who may perhaps have recognized con- 
geniality of pursuit as a stronger claim on their hospitality than 
mere professional brotherhood, I would express a peculiar ob- 
ligation ; and, should this acknowledgment ever reach them, I 
hope they will still further add to their kindness by excusing the 
use, which, under the impulse of feeling, I have ventured to 
make of their names on so public an occasion. 

The second division of practitioners before alluded to, or the 
proper surgeons, are those who profess to deal only with surgi- 
cal affections, with the addition in some instances perhaps of 
obstetrics. They do not seek a diploma in medicine, and have no 
special designation to distinguish them from other members of 
the community. To the eminent surgeon it is offensive to be 
styled doctor ; because the giving of a title, to which he has no 
claim, would seem to imply that his consequence may be added 
to by something extraneous to his own merits or position. 
Though none are prohibited by law from assuming the name 
and character of a surgeon, and some persons do so without any 
claims from qualification or otherwise, yet no one is recognized 



THE MEDICAL PROFESSION IN GREAT BRITAIN. 293 

as belonging regularly to the profession, or can gain a respect- 
able standing in the community, unless he has gone through a 
preparatory study and training, and received credentials from 
some authoritative body.* Such credentials are generally ob- 
tained from the Royal College of Surgeons of London, whose 
diploma of membership, given after a certain specified course of 
instruction, and a successful examination by the College, is 
everywhere received as sufficient authority to practise, and is 
sought for by most of those who have respect for themselves, or 
seek the respect of the community. A higher position still is 
that of fellowship in the College, which implies more ample lit- 
erary as well as professional attainment, and is conferred, after 
a satisfactory examination, upon candidates -who can bring the 
requisite certificates of previous preparation, such as that they 
are twenty-five years of age, have a competent knowledge of the 
Greek, Latin, and French languages, and have been engaged for 
six years in the acquisition of professional knowledge, in recog- 
nized hospitals and schools of medicine, either in the British 
Islands or abroad. 

I found a distinction made in England, in conversation, be- 
tween the surgeons and consulting surgeons, though I could not 
discover any very definite line between the two sections of the 
profession. The consulting surgeons, however, appear to be those 
who aim at, or have obtained the highest position among their 
fellows, who leave to others the humble offices of the profession, 
and confine themselves to the giving of advice at their houses, 
to the performance of operations, and to consultations. They 
are men of the highest attainment, respect, and influence in the 
communities in which they move, not unfrequently acquire con- 

* This is one of the points in which the late act of Parliament has 
proved very useful. No one now can assume the title of surgeon or 
physician, who is not legally, entitled to it. — Note to the -first edition, Dec. 
1859. 



294 THE MEDICAL PROFESSION IN GREAT BRITAIN. 

siderable wealth, and in many instances have, like the more suc- 
cessful physicians, been honoured by knighthood or a baronetcy ; 
the highest title which has ever yet been conferred on any mem- 
ber of any branch of the medical profession in Great Britain. 
Sir Astley Cooper, Sir Benjamin Collins Brodie, Mr. Travers, 
Mr. Stanley, and Mr. Liston are, or were, examples of this 
higher grade of surgeons. Mr. Norman, an eminent surgeon of 
Bath, and at the time mayor of that city, presided over the late 
annual meeting of the Provincial Medical Association, though 
numerous physicians, and some of them of high standing, were 
present. In short, I could not discover that any marked dis- 
tinction in social standing existed between the physicians and 
consulting surgeons. Both are, I think, generally deemed much 
superior, on the average, to the lower grade of surgeons, and to 
the general practitioners. 

This last class will next engage our attention. It is by far 
the most numerous, and, if I am not much mistaken, is destined 
to play an important part in the future medical history of the 
country. It took root in the once humble and despised apothe- 
cary, gradually grew upon the wants of the community, and has 
at last attained an overshadowing magnitude, which, though 
each individual branchlet may be of little significance, will 
probably in time, by its very mass, shut out the sunshine of 
public patronage from the hitherto more elevated classes, and 
cause them finally to wither in its shade. The original and 
proper business of the apothecary was no doubt to prepare and 
vend medicines ; and this it ought still to have continued to be. 
In the United States, he remains what he originally was ; and 
the consequence has been, that, by a concentration of time and 
abilities upon his own pursuit, he has elevated pharmacy from 
the rank of a mere trade to the dignity of a profession, and in- 
creased in a corresponding degree his own personal respecta- 
bility. It was otherwise in England. There, the apothecary, 



THE MEDICAL PROFESSION IN GREAT BRITAIN. 295 

though he continued to prepare and sell drugs, superadded the 
practice of the different branches of the medical profession to 
the pharmaceutical, which thus became secondary in his own 
estimation and that of the public. Without becoming a good 
medical practitioner, he ceased to be a good pharmaceutist ; and 
the name of apothecary came at length to signify a mongrel 
compound of doctor, man-midwife, surgeon, and drug vender ; 
a true jack of all trades and master of none ; willing to play 
second part to the regular physician, and, though used by 
the public, yet looked on by them with a sort of good-natured 
contempt* 

It is not difficult to account for the different results in the two 
countries. With us, the practice of medicine, if not quite free, 
was trammelled with very few restrictions, and those by no 
means onerous ; so that it was easy for any one possessing 
moderate means to enter the profession, the ranks of which were 
thus kept filled up to the wants of the country; while compe- 
tition placed the fees upon a level with the general means of the 
public- All the avenues to practice being occupied by those 
regularly trained to the pursuit, the apothecary had no oppor- 
tunity or temptation to step over the legitimate bounds of his 
profession into the empty places of medicine. In England, on 
the contrary, the regularly educated physicians were compara- 
tively few ; and these, enjoying a kind of monopoly, were enabled 
to maintain prices at such a point, as to place their services 
beyond the means of persons in low or moderate circumstances. 
The poorer people, unable to pay for instructed advice, turned 

* It will he readily perceived by the context, that this sentence was in- 
tended to apply to the apothecaries as they formerly were. Their stand- 
ing, at the time of my visit, was much more elevated; and, under the 
name of general practitioners, they constitute, upon the whole, a highly 
respectable branch of the profession. 



296 THE MEDICAL PROFESSION IN GREAT BRITAIN. 

to the apothecary, who, as a vender and preparer of medicines, 
was naturally supposed to know something of their uses. He 
thus became the adviser and attendant of the lower classes ; and 
even those of the upper ranks gradually began to employ him, 
first as a subordinate auxiliary to the physician, and at length 
as his substitute in mild cases, and the incipient stage of those 
of a severer character. Not being permitted to charge for his 
advice or his visits, he naturally sought to indemnify himself for 
his loss of time by an increased sale of his medicines ; and was 
tempted into various irregular modes of attaining this end, among 
which were excessive medication, the adaptation of the prescrip- 
tion to the pecuniary advantage of the prescriber rather than to 
the real wants of the patient, and a system of monstrous over- 
charging. I have been informed that it was formerly not uncom- 
mon for the apothecary to put up a dose of salts, worth two or 
three pennies, in half a dozen or a dozen potions, to be taken at 
intervals of an hour or two, each at the cost of a shilling. 

Conscience, and a proper sense of his interests, combined to 
induce the apothecary to render himself fitted, so far as possible, 
to the new office which had been in some measure forced upon 
him. He sought, therefore, in the hospitals and schools, and by 
a course of study, a competent knowledge of disease, and the 
recognized modes of treating it. Some attained great skill and 
reputation, and even raised themselves to the rank of regular 
physicians. Many, however, remained in contented inferiority 
or ignorance ; and the general standard of medical attainment 
among them was certainly not very elevated. The London 
Society of Apothecaries, who held the exclusive right, under the 
law, to grant licenses to practise their art, were by no means 
strict in their medical requisitions. The great majority of the 
people of England appeared to be doomed to intrust their health 
and lives to the chances of incompetent advice. But a new era 
has opened ; great advances have already been made towards a 



THE MEDICAL PROFESSION IN GREAT BRITAIN. 297 

better condition of things; and, on looking down the long vista 
of futurity, we may see the prospect gradually widening and 
improving for this branch of the medical profession, and that 
portion of the public intrusted to them. Formerly, though the 
practice of medicine had been grafted on pharmacy, the latter 
continued to be the main object of solicitude, as it was the chief 
source of profit. Gradually the medical branch has acquired 
increased vigour, growing upon the nourishment that was thrown 
into it at the expense of the parent stem, until at length it has 
expanded into a luxuriance which almost conceals the latter from 
view. The Society of Apothecaries established a higher grade 
of medical qualification for their licentiates, and sustained that 
grade by more rigid examinations. The education now de- 
manded of the apothecary, before he can obtain permission to 
practise, is of a character quite equal to the requisitions of our 
own schools. Independently of five years' apprenticeship, which 
is considered requisite for his due pharmaceutical accomplish- 
ment, he must be twenty-one years old, have attended three 
courses of winter and two of summer lectures in some recognized 
school, and at least a year in some recognized hospital contain- 
ing one hundred beds. Of the different branches of medicine, 
surgery alone is omitted from the schedule of studies. The 
apothecary, though a medical practitioner, is not necessarily a 
surgeon. But most of those who enter into this division of the 
profession, qualify themselves also, as I was informed, for the 
practice of surgery, and become members, after due examination, 
of the College of Surgeons of London. They thus lay them- 
selves out for the practice of every branch of our art, exactly as 
the country physician in the United States ; and, in correspond- 
ence with this position, they are beginning to throw aside the 
title of apothecary, and to assume that of general practitioners. 
Until recently they were allowed to charge only for medicines ; 
the advice and attendance being thrown into the bargain. At 



293 THE MEDICAL PROFESSION IN GREAT BRITAIN. 

present, according to the decision of the courts of law. they can 
charge for both: and one great and most absurd evil has thus 
been corrected. The English general practitioners are now 
almost precisely upon a footing with the greater number of 
physicians in the United States, differing simply in the circum- 
stances, that they do not take the degree of doctor of medicine, 
and, in most instances, continue to unite the business of the retail 
druggist with that of the physician. They universally make 
lower charges than the usual fee of the physician in England, 
receiving, I believe, generally, from those who can afford it, five 
shillings instead of a guinea for each visit. They enjoy the 
advantage, also, if it can be considered one, of having a legal 
claim for compensation for their services : and. as with us,, they 
render their bills at stated periods, instead of receiving their fee 
in hand. It is easy to foresee that, with increasing competence, 
and a still more enlarged instruction, they must raise themselves 
in time to be the almost exclusive medical practitioners of the 
land; for low prices, with equal qualifications, will in the long 
run invariably carry the day. The very wealthy, and the high 
aristocracy, may long continue to cherish the distinction of a 
physician at a guinea a visit ; but even they will, I think, in 
time, come into the five shilling system, when they learn that 
the great point of health can be equally well secured. But, 
before this end arrives, a great change is yet to take place in the 
plans of the general practitioner. It will be necessary for him 
to devote an exclusive attention to the medical department of his 
profession, and to cut loose from the pharmaceutical, which must 
be abandoned to the chemist and druggist, or in other words, the 
legitimate apothecary. 

Were time allowed me, it would be easy to point out the evils 
which flow from the combination of these two pursuits in one. 
As it is, I must content myself with a hasty sketch of them. 
They who are but superficially acquainted with the various 



THE MEDICAL PROFESSION IN GREAT BRITAIN. 299 

qualifications required in the practitioners of medicine and 
pharmacy, know well that either one of them is sufficient to 
engross all the time and powers of a single individual ; and that 
he who undertakes to unite them must, as a general rule, do so 
at the expense of proficiency in one, or the other, or in both. 
This alone is an all-sufficient reason why they should be sep- 
arated. But there are others. The medical practitioner who 
prepares and dispenses medicine is constantly exposed to the 
temptation of over-medication if he charge for his medicines, of 
under-medication if he make no charge ; and if, in his capacity 
of apothecary, he be called on to put up the prescriptions of 
others, he is again tempted to an undue interference with the 
physician, by undervaluing whose skill he is indirectly raising 
his own in the estimation of the patient, and paving the way for 
an extension of his practice. The majority may resist these 
temptations ; but some undoubtedly yield to them, and thus affix 
a stigma to the whole body, which has a tendency to indispose 
young men of the highest qualifications from joining it, and con- 
sequently lowers somewhat not only its general reputation, but 
its real efficiency. The general practitioners of England can 
never place themselves on a level with the physicians and higher 
grade of surgeons, until they shall have effected the separation 
alluded to ; and we shall do well in this country to take warning 
from English experience, and scrupulously continue to keep the 
two professions distinct. In relation to practitioners in thinly 
peopled neighbourhoods, where apothecaries' shops are not 
accessible, it is necessary that the physician should himself dis- 
pense medicines to his patients ; but it is not necessary that he 
should make a business of their preparation and sale, and thus 
load himself with the burdens and responsibilities of another 
profession. 

From what has been said you will have inferred that the 
organization of the profession in England is very complex. It is 



300 THE MEDICAL PROFESSION IN GREAT BRITAIN. 



•% 



even more so than I hare described it, in consequence of the 
varying action of different bodies, having or professing to have 
peculiar legal powers, or at least exercising by prescription 
peculiar influences which have almost the force of law. Thus, 
connected with the Royal College of Physicians are two if not 
three classes of practitioners ; with the Royal College of Sur- 
geons, two ; with the Society of Apothecaries, a third ; while, 
in the instance of new regulations in any of the institutions, 
there is necessarily one class of those in existence before their 
adoption, and another of those who enter the profession after- 
wards. The degree, moreover, of different institutions is of dif- 
ferent weight, that of Oxford and Cambridge being perhaps 
more highly esteemed than that of Edinburgh or Glasgow, or of 
the foreign universities. In fact, upon making inquiry of some 
of my medical friends in England, I found that even there all 
the entangled relations of the different sections of practitioners 
were not by any means universally understood. From this 
cause it has happened that the movements in the profession, 
which a sense of its imperfect organization has occasioned, 
and the extent of which indicates a general dissatisfaction and 
restlessness under the present system or want of system, have 
hitherto been productive of no very important results. The law- 
makers have shown a disposition to aid the profession in work- 
ing its way out of these intricacies ; but a movement made in 
any one direction is apt to be met by the remonstrances of some 
opposing privilege, interest, or prejudice ; and legislative inter- 
ference appears to have been postponed until some plan can be 
presented, which shall unite the suffrages of the great body of 
those concerned. I cannot but think that the sagacity and judg- 
ment so characteristic of the English will ere long be brought to 
bear on this confused subject, and that measures will be devised 
calculated to bring about harmony if not perfect unity in the 
profession ; so that the struggle as to what peculiar interest shall 



THE MEDICAL PROFESSION IN GREAT BRITAIN. 301 

be best promoted or defended, will give way to an emulous rivalry 
in furthering the general good. There should be one education 
and one grade of honour common to all ; and everything else 
should be left to individual effort. Some, as at present, would ad- 
dict themselves to medicine, some to surgery, some to midwifery, 
etc.; and many would combine the three branches together. The 
more special practitioners might be slower of success, but would 
in the end acquire greater skill and reputation, and consequently 
greater emolument ; and there would be an ample field for the 
gratification of an honourable ambition on the broad basis of 
equal rights and privileges to all.* 

The remarks hitherto made have had reference chiefly to the 
organization of the profession ; but the view would be very in- 
complete in your eyes, were I not to present } r ou some account 
of the plan of medical education, and the qualifications demanded 



of the candidate for the medical diploma, or in other words, for 
the certificate of qualification to practise. You will be surprised 
to learn that none of the proper medical schools in England, and 
none of the literary institutions with which they are directly con- 
nected, have the power either of conferring degrees, or of giving 
a license. The only graduating bodies are the Universities of 
Oxford, Cambridge, and London. The first two grant medical 
honours to those exclusively who have completed a course of 
academic study under their own supervision, unless perhaps the 
graduates of the Dublin University may constitute an exception; 
the last extends them to all who can present the requisite cre- 
dentials, and undergo the requisite examinations, no matter in 
what school or schools their medical education may have been 

* I scarcely need repeat that, since this lecture was delivered, an act of 
Parliament has been obtained, which, though it is not all that could be 
wished, has enabled the profession to organize itself, and promises to 
lead to very useful results. — Note to the first edition, Dec. 1859. 



302 THE MEDICAL PROFESSION IN GREAT BRITAIN. 

conducted, provided only that the school be one recognized by 
the University, and, of the four years of scholastic attendance 
required, one year at least shall have been in connection with 
one or more of the schools of the United Kingdom. Attached 
to the Universities of Oxford and Cambridge there are professor- 
ships in the medical sciences, and, in the latter, courses of in- 
struction are given ; but in neither is there a complete school. 
The University of London has not even the shadow of a school 
attached to it; for the University College of London, whose 
medical class is I believe the largest in England, has no more 
connection with the University of London, notwithstanding the 
similarity of name, than any of the other respectable schools 
upon the island. The University is merely an examining and 
degree-conferring body, established by government in order that 
dissenters might be enabled to obtain academic and medical 
honours ; the graduates of Oxford and Cambridge being required, 
I believe, to profess adhesion to the national church. 

The schools are generally established in association with hos- 
pitals ; the prescribing physicians and surgeons of these institu- 
tions uniting to get up courses of instruction in the different 
branches of medicine and surgery ; and so necessary is the hos- 
pital connection deemed, that, when independent schools are in- 
stituted, they endeavour to set on foot an infirmary, to be under 
the charge of the teachers, as in the cases of the King's College, 
and the University College, in London. Had I time, I could 
easily demonstrate, to your satisfaction, that this plan of forming 
schools as subsidiary to the hospitals can never be permanently 
and greatly successful. The chief objection to it is that the 
officers are appointed, not in reference to their qualifications as 
teachers, but for the practical charge of the infirmary. It may 
accidentally happen that one or more of them may possess high 
teaching powers ; but a succession of such happy accidents can 
scarcely be expected ; and the reputation of the school must be 



THE MEDICAL PROFESSION IN GREAT BRITAIN. 303 

temporary. No great school of the kind has maintained a perma- 
nent existence in England ; no one in fact has ever risen into the 
eminence which institutions have attained, based upon the prin- 
ciple, that peculiar qualification for the duties to be performed 
should be the ground of appointment. The most successful 
school in London has been that of the University College, in 
which the professors are chosen for their professorial abilities, 
and not for their fitness, either from favour or qualification, for 
the office of physician or surgeon to an hospital. 

Schools are numerous both in London and the provinces. In 
the former, thirteen are recognized by the London University, 
in the latter no less than sixteen, of which the most distinguished 
are those of Manchester and Birmingham. Many of these schools 
are imperfect ; but, as the requisition for graduation or a license 
is that the candidate shall have attended courses on certain sub- 
jects, for a certain length of time, he may receive his instruction, 
if he see fit, in several distinct schools, attending to one subject 
in one and to another in another ; so that any deficiency in the ar- 
rangements of a school, as to the subjects taught, may be easily 
supplied. Most of the schools are very slenderly attended ; many 
having classes of considerably less than fifty pupils, while the 
most flourishing seldom exceed two hundred, or two hundred 
and fifty. 

The population of England cannot support so large a propor- 
tionate number of practitioners as ours, in consequence of the 
vast excess of the poor, who never pay for medical aid. This 
class of the population can contribute to increase the number of 
practitioners, only in so far as the medical assistance yielded 
them is paid for out of the public purse ; but the compensation 
thus given is so ridiculously insignificant, and the numbers of 
the poor whom it is expected that each practitioner employed 
for the purpose shall attend is so absurdly great, that but a small 
addition can be made to the aggregate number of medical men 



304 THE MEDICAL PROFESSION IN GREAT BRITAIN. 

upon this score. The inadequacy of the compensation made by 
the public for attendance on the poor, is one of the most common 
and loudest complaints of the profession ; and I have heard the 
strongest terms of reproach lavished on the wretched parsimony, 
which exhausts and impoverishes the medical practitioner, while 
professing to pay him for his services. I remember being told 
that the practitioners employed by the government, during the 
prevalence of the typhous epidemic, which has recently been 
desolating Ireland, were expected to expend their whole time, 
and more than all their energies, in visiting the destitute sick 
over wide tracts of country, for the miserable pittance of five 
shillings a day; scarcely sufficient to pay for their necessary 
horse-hire. Why, it may be asked, should they submit to be 
thus treated ? The answer simply is, that, placed as they are in 
the midst of the perishing poor, they are compelled by the ordi- 
nary feelings of humanity to make every possible effort for their 
relief; and the government, with the spirit of a usurer preying 
upon the struggles of the unfortunate, speculates upon their 
benevolence. The consequent exposure and hardships prove 
extremely destructive to the practitioners thus employed ; and I 
heard one of the most eminent of the physicians of Ireland say, 
in the most mournful and touching accents, that one-fifteenth of 
all the medical men of that island had perished in the year 1847, 
chiefly of typhus fever. The evil is not so great in England ; 
but it is even there universally looked on by the profession as a 
most crying grievance, a piece of enormous injustice, which the 
public are called on by every principle of right, and every feeling 
of humanity, to rectify. 

If the whole number of students is small, that of the candi- 
dates for the degrees in the universities is incomparably less ; 
and I was astonished to learn that the University of London 
does not graduate more than ten or eleven annually. I was told 
that, in all London, there were probably at no time more than 



THE MEDICAL PROFESSION IN GREAT BRITAIN. 305 

from eight hundred to a thousand students of medicine; and of 
these but a small proportion is engaged in attendance at the 
same time upon all branches; so that, divided among the thir- 
teen recognized schools, the average class of each individual 
teacher must be small. I do not know that it is a legitimate 
matter of boasting ; but the fact is certainly worthy of notice, 
that, while London, the metropolis of the world, with two mil- 
lions of inhabitants, has little more than eight hundred medical 
pupils, Philadelphia, with only one-sixth of the population, counts 
her thousand or twelve hundred every winter. 

It may be expected that I should detail the qualifications 
deemed essential for admission into the different classes of prac- 
titioners respectively; but time is wanting, and I must be con- 
tent with stating that, in relation to preliminary education, 
length of study, amount of knowledge, and age of admission, 
the requisitions for the highest class are much greater than with 
us, while, for those of a lower grade, they are about the same. 
Thus, four years of study are demanded by the University of 
London as preliminary to the degree of Bachelor, six years to 
that of Doctor of Medicine; the Royal College of Physicians 
and that of Surgeons require, the former five and the latter four 
years ; and the Apothecaries' Society exacts of every candidate 
for their license, which constitutes the only legal authority of 
the general practitioner, besides an apprenticeship of five years 
with an apothecary, an attendance upon not less than three 
winter and two summer sessions of lectures. 

Notwithstanding these higher requisitions upon paper, were I 
called on for an opinion as to the relative qualifications of the 
medical men in England and the United States, though con- 
fessedly not possessed of all the means of forming an accurate 
judgment, I should say, from what I have observed, that, if the 
higher grades of English physicians are superior in education to 

ours, the case is reversed in relation to the great mass of practi- 

20 



306 THE MEDICAL PROFESSION IN GREAT BRITAIN. 

tioners. The main cause of this superiority on our part, admit- 
ting it to exist, is probably that the American practitioner reads 
much more, after the nominal completion of his studies, than 
the English, of which one of the strongest proofs is the com- 
paratively small editions of medical books sold in England. 
Their own best works are more read in the United States than 
at home. My friends in England appeared to be astonished 
when informed of the number of medical books sold in the 
United States. Perhaps one cause of this difference may be, 
that the great body of English practitioners, being apothecaries, 
have their time too much engrossed by the pursuit of two dis- 
tinct branches of business to allow much of it to be devoted to 
further study. 

It remains only that I should give a hasty sketch of the organi- 
zation of the profession in other parts of the United Kingdom. 
In Ireland, it is almost an exact copy of that existing in Eng- 
land : the same classes of practitioners ; the same licensing and 
graduating authorities ; the same system of medical instruction. 
There are in Ireland, as in England, physicians, surgeons, and 
apothecaries. Dublin has its King and Queen's College of 
Physicians, its Royal College of Surgeons, and its Apotheca- 
ries' Hall, closely analogous in their constitution and privileges 
to the corresponding institutions in London. There is also the 
Dublin University or Trinity College, which confers degrees in 
medicine ; but differs from the English universities in having a 
completely organized school of medicine connected immediately 
with it j in this respect, resembling the Scotch universities and 
our own. But there are numerous other schools in Dublin, 
private or connected with the hospitals, in which the large 
classes of the surgeons and apothecaries mostly receive their 
education ; but they neither confer degrees, nor give any license 
to practise. Most of the students who aim at the medical degree 
resort, or until recently have resorted, to the Universities of 



THE MEDICAL PROFESSION IN GREAT BRITAIN. 30T 

Edinburgh and Glasgow. I was told that the class of apothe- 
caries or general practitioners are not equal in attainment to 
the English ; as the Dublin Apothecaries' Hall is less rigid in 
its examinations, and less exacting in its requisitions than the 
analogous society of London. The two degrees of Bachelor and 
Doctor of Medicine are conferred by the Dublin University, the 
former being regarded as a sufficient license to practise, and the 
latter merely as an honour. 

In relation to Scotland, I confess that I have less precise in- 
formation than of the two other sections of the kingdom. My 
journey through North Britain was so rapid, and my attention 
so much engrossed by other objects, that I failed to make full 
inquiries. But, from what I did see and hear, and from the com- 
parative facility with which the degree of Doctor of Medicine, 
hitherto, I believe, the only one conferred by the Scottish schools, 
may be obtained, I have inferred, that physicians, or, in other 
words, graduates in medicine, are much more numerous propor- 
tionably in this than in the southern section of the island, or in 
Ireland ; and that, as with us, they perform all the offices of the 
profession ; some directing a more exclusive attention to the 
pure practice of medicine, others to surgery, and others again to 
obstetrics. There is, however, a distinct body of surgeons, who 
practise under the license of the Edinburgh College of Surgeons, 
the Glasgow Faculty of Physicians and Surgeons, or some simi- 
lar institution, without having obtained a degree. I heard of no 
class precisely analogous to the apothecaries or general practi- 
tioners of England. 

The bodies having the right to confer the degree of Doctor of 
Medicine in Scotland, are the Universities of Edinburgh, Glas- 
gow, Aberdeen, and St. Andrews, and the King's College of 
Aberdeen. Of these, the Universities of Edinburgh, Glasgow, 
and Aberdeen, have medical schools connected with them, ex- 
actly as the University of Pennsylvania. All profess to require 



30 S THE MEDICAL PROFESSION IN GREAT BRITAIN. 

four years of attendance upon medical lectures ; and most of the 
courses of lectures are required to be of six months' duration, 
which is the case also in the English schools. Besides these 
graduating institutions, there are three which have the power 
of licensing ; namely, the Royal College of Physicians and the 
Royal College of Surgeons of Edinburgh, and the Faculty of 
Physicians and Surgeons of Glasgow. There is a respectable 
medical school in Glasgow, connected with the institution called 
commonly, from its founder, the Anderson University, which has 
not, however, I believe, any legal collegiate powers. 

The observations, already incidentally made, will spare me 
the necessity of speaking further of the general character of the 
medical profession in the British Islands. Upon the whole, I 
presume, their relative social standing is equal or superior to 
that of the profession in any other country in Europe, though 
inferior to that which is enjoyed in the United States, where, I 
am proud to say, the medical men as a body maintain a position 
with the highest, whether we take, as a measure of elevation, 
extent of attainment, sentiments of honour and of humanity, 
cultivation of manner, or the respect of the community. 

There is, however, one point of which I would speak before I 
close. I wish to call your attention emphatically to the hos- 
pitable qualities of the medical practitioners of the United 
Kingdom, and especially to their kindly disposition towards 
their professional brethren in this country. Wherever I went, 
throughout the islands, it was only requisite that I should be 
known as a physician from the United States, of ordinary repute 
at home, to secure me the kindest reception; and the want of 
time often compelled me to forego hospitalities that were urged 
upon me. I may be allowed, perhaps, to mention one instance 
in proof of what I have stated. Arriving towards the close of 
the day at one of the chief cities of England, I left my own card 
with another of introduction at the door of a physician of the 



THE MEDICAL PROFESSION IN GREAT BRITAIN. 309 

place. After dark, he called upon me, stating that he had come 
immediately after receiving my card ; and, having been told that 
we should depart on the following morning, insisted upon taking 
me at once over the town, and showing me as much of it as 
could be seen by the light of a beautiful moon, which had risen. 
I agreed to the proposal, and together we wandered through the 
streets and lanes, and about the walls of the city till it was 
nearly midnight. In the course of our peregrinations, I observed 
that remarkable respect was everywhere paid to my companion 
by the police ; and, before returning to my quarters in the hotel, 
learned that I had been under the guidance of the mayor of the 
city. This act of extraordinary courtesy, with others which 
greatly facilitated my objects in travelling through that section 
of the country, I shall always bear in very pleasing remembrance. 
All of you know of the meeting of the American Medical As- 
sociation at Baltimore in May last. At that meeting, a delega- 
tion was appointed to represent the body in the British Provin- 
cial Medical Association which was to assemble at Bath in 
August. Among others, I myself, being in England at the 
time, was named upon the delegation ; and, wishing to give 
effect to the intentions of the Association, I made arrangements, 
though at the expense of my previous plans, to be present at the 
meeting. My reception was, beyond all expectation, kindly 
and respectful. The credentials were read ; resolutions of the 
most flattering character were passed unanimously ; and the 
whole meeting rose to greet the messenger of good-will and 
brotherly sentiments from beyond the Atlantic. I was of course 
gratified ; I can hardly express how highly gratified ; not so 
much at the honour done to me, as to my country through me. 
These expressions and evidences of mutual good-will are of the 
highest national importance. A reciprocity of kindly feeling 
can scarcely actuate distinct masses of intelligent men, such as 
compose the medical profession in England and America, with- 



S10 THE MEDICAL PROFESSION IN GREAT BRITAIN. 

out radiating more or less through their respective communities, 
and thus serving as a bond of peace and amity between two na- 
tions, whose mutual good-will is essential to the prosperity and 
happiness of both, and which, if united in the prosecution of 
the great object of human advancement, will exercise the most 
happy influence over the destinies of the whole earth. Let me 
urge upon you, gentlemen, to do all that lies in your power, by 
the cultivation of this friendly spirit towards your British 
brethren, to further so desirable a consummation. 



LECTURE II 



DELIVERED OCTOBER 14th, 1853. 



The Medical Profession on the Continent of Europe. 

Gentlemen : — 

Most of you are probably aware that I have been spending 
the season just passed in a tour upon the Continent of Europe. 
From the relations subsisting between us, you may very reason- 
ably expect from me some fruit of this journey, that may be use- 
ful to you in your capacity of students of medicine. You will 
not, therefore, I trust, ascribe it to presumption on my part, or 
an overweening disposition to obtrude myself on your notice, If 
I attempt to answer such an expectation by offering to you some 
of the observations and reflections, of a medical character, which 
I have had occasion to make in the course of the journey. 
Should you discover signs of haste and carelessness in my com- 
munication, I must beg of you to remember that it has been 
prepared in the course of a few days, amidst crowded occupa- 
tions, and immediately upon returning from a long absence, and 
to make all due allowances. 

You will, I hope, excuse me, if, in the first place, I give you a 
very brief sketch of my route, so that you may know what have 
been my opportunities of observation, and thus be able to esti- 
mate more accurately than you otherwise could do the value of 

(311) 



312 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

niy statements and opinions. It is proper to say that I was 
accompanied throughout the journey by my friend, Professor 
Franklin Bache, of the Jefferson School, and have consequently 
had the advantage of an excellent auxiliary judgment, in con- 
sidering the various facts that came under our joint notice. 

Having made a rapid passage to Liverpool, and remained a 
short time in London, we reached Paris early in May, and, about 
the middle of the month, left that city for the south of France. 
Upon our route in this direction, we visited Bordeaux, Montpel- 
lier, and Marseilles, and afterwards, entering the dominions of 
the King of Sardinia, passed through Nice, Genoa, and Turin, 
and crossed Mont Cenis, then covered at its top with snow, 
though so late as the seventh of June. I would here inci- 
dentally remark that, during almost the whole of our journey, 
the weather was unusually cool, and at the very time that, here 
at home, you were scorching with the intensity of the heat, we 
found fires in the evening necessary to comfort, on the shores of 
the Mediterranean. I was told at Xice that the coldness of the 
weather was almost unprecedented at that place. The chief 
interest of this fact is the evidence it affords, so far as it goes, of 
a compensating influence in the distribution of terrestrial temper- 
ature, by which what is lost by one part of the earth is gained 
by another ; so that the invalid may indulge the hope of escap- 
ing an uncongenial season in his own country by a voyage over 
the ocean, now reduced to a mere trifle, in point either of time or 
trouble. From Savoy we entered Switzerland, and, having 
visited Geneva, Berne, Zurich, and other noted towns of that 
glorious region, crossed the Lake of Constance, and prosecuted 
our journey through Augsburg, Munich, Saltzburg, etc., to the 
Austrian capital. From Yienna, where we spent a few busy 
days, we proceeded northward through Bohemia, Saxony, and 
Prussia, to the shores of the Baltic, giving, as we passed, a 
short time to the cities of Prague, Dresden, and Berlin. De 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 313 

scending the Oder from Stettin, we steamed over the Baltic 
to Stockholm, visited the famous Upsala, once the capital of 
Sweden, and long the site of its most famous school, then re- 
turned to Stettin, and took a fresh start thence up the Baltic 
and Gulf of Finland, to St. Petersburg. 

An interesting medical fact, in connection with this part of our 
tour, was that, notwithstanding the existence of quarantine regu- 
lations, enforced with extreme strictness, between Sweden and 
all the ports of the Baltic where cholera was known to have ap- 
peared, the disease, nevertheless, entered Stockholm, and had 
begun to spread with considerable violence before we left the 
north of Europe. Sweden is, I believe, at present the only 
country in Europe where quarantine laws are 'enforced against 
the disease ; as experience has shown that they are altogether 
futile for any good result, while they prove of great inconven- 
ience to the traveller, and the source of much commercial loss.* 

Another medical fact of some interest is the prevalence of a 
mild form of intermittent fever in the neighbourhood of Stock- 
holm, in the latter part of summer and beginning of autumn. I 
was much surprised at this ; for, though the country is full of 
lakes and inlets from the sea, and shows upon the map almost 
as much of water as of land, yet the region is, I believe, wholly 
granitic, and the latitude is considerably beyond the highest point 
at which marsh miasmata are usually supposed to be generated. 

But to return to my narrative, which was broken in upon by 
these reminiscences, I will merely further state that, having 
made a short visit to Moscow, we left Russia, and returned 
southward through Germany, Holland, and Belgium, to Paris, 
visiting by the way, among other cities, those of Frankfort-on- 
the-Main, Cologne, Amsterdam, the Hague, Leyden, Antwerp, 

* I have been informed that, since the period of our visit, the quaran- 
tine laws, so far as they related to cholera, have been abolished. 



314 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

and Brussels. From Paris, we came homeward by the route of 
London and Liverpool, and, after a stormy passage of nearly 
twelve days, reached New York on the second instant, rejoiced 
once again to be in our own land, which all that we had seen 
abroad had but taught us to love and esteem the more. 

During the journey, of which I have thus given a very brief 
sketch, we availed ourselves of every offered opportunity of 
examining the medical schools and hospitals, and making our- 
selves acquainted with the state of the profession in the several 
countries visited. I owe it to the medical men whom we met 
to state that, almost without exception, they treated us with 
courtesy and even kindness, and took apparent pleasure in facil- 
itating our inquiries. 

The great rapidity of our progress, and the numerous objects 
of interest unconnected with medicine, which met us at every 
step, and required a portion of our attention, precluded a 
minute investigation ; and it is, therefore, general views rather 
than detailed statement, or elaborate description, which I have 
to offer. Fortunately this corresponds with the requisitions of 
the present occasion, wherein time is not allowed, and attention 
could scarcely be commanded for minute and copious details. 

In a former address to the medical class, which they did me 
the honour to publish, I presented some views of the state of the 
medical profession in Great Britain, which render further refer- 
ence to that subject unnecessary now. The observations I am 
at present about to make will relate to the continent, and to that 
portion of it only through which our route lay ; the Spanish, 
Italian, and Grecian Peninsulas, and the European dominions of 
the Sultan, not being included. 

The first and most important element in the consideration of 
the subject is medical education. No course of argument is re- 
quired to show that this must lie at the foundation of the pro- 
fessional character in every country ; and that, according as it 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 315 

is well or ill conducted, and to the special manner in which it is 
conducted, must, in great measure, be the condition of the pro- 
fession itself, in regard not only to its general efficiency and re- 
pute, but also to its peculiar and characteristic traits. 

Throughout all those parts of Europe referred to, medical 
education is carried on essentially in the schools. These are 
never, so far as I had the opportunity of noticing, independent 
establishments, like many existing in our own country, but are 
always connected with some great general school or university, 
from which the honours emanate, after compliance on the part 
of the candidate with certain regulations, among which the most 
important are a particular duration of study, and examinations 
at fixed and frequently recurring periods. 

The laws of the country have an important bearing upon 
medical education. In general, no person is allowed to practise, 
who has not obtained a license or degree from a university or 
other analogous institution. This gives great authority to the 
schools, enabling them to make and enforce regulations, and 
exact an amount of attainment on the part of the candidate, 
which they could do in no other way so efficiently. Even with 
this advantage, however, they do not always succeed in making 
good and accomplished practitioners. Competition, so useful 
when properly restrained and regulated, becomes here, as in 
almost everything else, when left to an unrestricted course, the 
cause of some evils. In the large states, where one will, 
whether that of a despot or of a constitutional authority, con- 
trols all things relating to education, it is comparatively easy to 
proportion the number and extent of the schools to the wants 
of the community ; but the case is far otherwise when many 
small independent governments exist, each with the power to 
establish as many schools as it may see fit, but often not pos- 
sessed of the resources and materials requisite for the support 
of one. In instances of this kind, the school must depend for 



316 THE MEDICAL PROFESSION IX CONTINENTAL EUROPE. 

its success upon a reputation extended beyond the limits of the 
state in which it has been established, and upon the induce- 
ments it can offer to students from all quarters. Now, such is 
the condition of things in Germany, where a large number of 
small sovereignties exist, each ambitious to distinguish itself by 
its scholastic institutions, and greedy of the advantages of vari- 
ous kinds which these institutions, when successful, yield to 
them. So far as the competition is limited to the earning of a 
reputation for efficiency of system, or excellence of instruction, 
it is productive only of good ; but, unfortunately, all cannot win 
for themselves such a position, nor, having gained it through 
the extraordinary efforts of gifted men, can they retain it when 
no longer supported by the same talent and energy. Under 
these circumstances, the temptation is sometimes irresistible to 
compensate for deficiency of merit by a reduction of the stand- 
ard of qualification, and, if the enterprising and highly gifted 
cannot be attracted, at least to secure the economical advantages 
by filling the rooms with materials of a lower order, and send- 
ing forth into the world, with the stamp of the school, unquali- 
fied men, who are more able or willing to pay for their honours 
than to earn them. I was informed, in Russia, that throngs of 
the inferior graduates of some of the German schools make their 
way into that country, and that it had become necessary there, 
though, from the vast extent and population of the empire, there 
is an almost unlimited field for the exercise of competent medi- 
cal abilities, to guard the public against this sort of regular 
charlatanism, by a rigid system of examinations, to which every 
one must submit, before he can be permitted to practise. 

The long duration of the term of study in the European 
schools is one of their important characteristics. So far as my 
information extends, this varies from four to six years, being in 
no instance shorter than the former of those periods, which, as 
all of you know, is one year longer than the longest with us. 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 317 

This is certainly an advantage which they possess over us ; and 
it might be inferred, with apparent reason, that, supposing the 
capacity and industry to be equal, the result must be a great 
superiority of professional qualification in the European gradu- 
ate. Yet, when examined in all its bearings, the longer period 
will not be found to possess all the practical advantages which, 
on a superficial view, might be ascribed to it. The system of 
instruction in the schools of Europe embraces, not only the 
studies having a close and essential connection with medicine, 
but also various accessory sciences, which, though creditable 
accomplishments, and to a certain extent useful to the physician, 
have little or no direct influence either in improving our knowl- 
edge of disease, or rendering us better able to treat it success- 
fully. The various branches of natural history, included under 
the titles of mineralogy, botany, and zoology, are of this kind. 
The excess of the European period of pupilage over ours is, in 
a considerable degree, occupied with such studies as these; and 
thus the real difference, so far as concerns strict medical science, 
is less than at first sight it might seem to be. Upon the whole, 
probably, the tendency of the European plan in this respect is 
to produce graduates of higher scientific attainments, and prob- 
ably of more thorough anatomico-pathological knowledge than 
ours, but little, if at all, superior as practical physicians. 

Another highly important feature of the European system is 
the succession of studies, with periodical examinations. The 
whole period of instruction is divided into annual or semi- 
annual terms, to each of which are ascribed certain branches of 
study ; and, before advancing from one of these terms to the 
next, it is required that the pupil should submit to an examina- 
tion as a test of his proficiency. This is clearly the proper 
method of teaching. The pupil begins at the foundation, and 
regularly proceeds with the structure of knowledge, until the 
whole original design is completed. He does not, as is too fre- 



318 THE xMEDICAL PROFESSION IN CONTINENTAL EUROPE. 

quently the case with us, attempt to carry on all parts of the 
edifice at the same time, or, as we sometimes do, begin at the 
top and build downwards. The study is thus rendered at once 
more easy and more fruitful. In the United States we pursue 
to a certain extent the same plan, when the student resides for 
the whole period of instruction in the near vicinity of the 
schools. But coming, as most of you do, from a distance, and 
spending but the half of each year in the schools, it would not 
be practicable to carry the plan into full effect, unless by a pro- 
longation of study, and amount of pecuniary outlay, which 
would be extremely inconvenient, and for many next to impossi- 
ble. In a considerable degree, this inconvenience may be obvi- 
ated by the system of private office instruction established in 
this country, by means of which the pupil may be carried 
through a regular course of studies and examinations upon the 
elementary branches in their due succession, and may thus come 
to the lectures, prepared to understand and avail himself of 
what he may hear upon all the branches. It is true that this, 
even when well carried out, is but a partial substitute for the 
plan of regular and successive attendance upon public instruc- 
tion from the beginning ; but it is the best that can be adopted 
for the great mass in the circumstances of our country ; and it 
is very important that private teachers everywhere should feel 
themselves under a conscientious obligation to give it full effect, 
by a proper guidance of the studies of their pupils, and frequent 
and thorough investigations into their proficiency. 

Still another characteristic of the European schools is the im- 
portance attached to clinical instruction. Instead of being, as 
with us, a subordinate and, as it were, incidental branch, gen- 
erally more or less defective, and sometimes altogether neglected, 
it is there recognized as indispensable, and, indeed, constitutes 
one of the most prominent features in the system of the schools. 
On this account, hospitals are considered as essential acces- 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 319 

sories ; and in all Europe I did not see a single medical school, 
which had not one or more of these establishments associated 
with it. In some instances, indeed, the hospital is the chief 
part of the school, and the only practical lectures given, whether 
in medicine or surgery, are within its walls. In general, how- 
ever, it is subordinate, and made by legal arrangements dependent 
on the scholastic institution. I need not dwell on the vast ad- 
vantages of this method of teaching medicine. The importance 
of demonstration in lectures upon all medical subjects is now 
almost universally admitted. It is the main point in which a 
system of oral instruction is superior to one of mere private 
reading or study; and surely no mode of demonstrating disease 
is so effective as that of exhibiting the patient himself in all the 
different phases of his disorder, and in all the modifications of his 
condition produced by treatment. Every method of demonstra- 
tion is more or less useful ; and hence, what have been erro- 
neously called school-clinics, which have for some years past 
been in such great favour in this country, are not without their 
advantages. But it would be a great mistake to consider them 
as sufficient substitutes for hospital instruction. It is impossible 
by means of them, to demonstrate satisfactorily severe acute 
affections, the regular progress of disease from beginning to end, 
or the morbid anatomy of cases terminating in death. It is 
mainly in consequence of the number and easy accessibility of 
the hospitals, that Paris has gained its present enviable position 
as the great world-centre of medical instruction. In other re- 
spects, I could not discover that the student enjoyed better op- 
portunities there than are offered to him in Philadelphia. In 
Paris, the hospitals not only serve the purpose of medical and 
surgical demonstration, but afford also extraordinary facilities 
for the prosecution of practical anatomy, both normal and patho- 
logical. There were few things in that magnificent city which 
more struck and interested me than the establishment denomi- 



320 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

nated " The Amphitheatre of the Hospitals." It consists of 
buildings admirably arranged for the purposes of post-mortem 
examination and anatomical dissection, whither are brought all 
the unclaimed dead bodies from all the hospitals of the city, pre- 
paratory to interment. Students, who have been regularly 
enrolled in the " School of Medicine," have the privilege of gra- 
tuitous admission to these rooms, where to every class of five 
one body is given every ten days, as I was informed ; thus 
affording them ample opportunities not only for pathological in- 
vestigation and for dissection, but also for surgical improvement 
by the frequent performance of operations on the dead subject. 
So complete are all the arrangements, that a small plot of 
ground, in the immediate neighbourhood of the dissecting apart- 
ments, has been planted with trees, and furnished with seats ; 
so that in the summer, the student, when tired of his work, 
may seat himself under the shade, in the cool air, and, while 
enjoying his rest, may add the luxury of a cigar, if it please 
him. Imagine him to yourselves leaning backward in one chair, 
with his legs, more Americano, stretched out upon another, and, 
as he puffs forth the smoke from the corner of his mouth, watch- 
ing its curling ascent with a placid air, that speaks volumes of 
interior contentment. I think, gentlemen, if you ever visit Paris 
for the purpose of professional improvement, you will not over- 
look the Amphitheatre of the Hospitals. 

I will take my leave of the subject of the hospitals for the pres- 
ent, by remarking that it is impossible to value them too highly 
as auxiliaries to a course of medical instruction ; and what we 
most need in this country is a more thorough union, or at least 
a more hearty and full co-operation of these institutions with the 
schools. 

The plan of private medical tuition in vogue throughout the 
Union has a tendency, in some degree, to supply the want of 
hospital opportunities. The student in the intervals between the 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 321 

courses of public instruction, may often see and even manage 
cases of disease under the guidance and oversight of his pre- 
ceptor, and, if both perform their parts diligently and consci- 
entiously, may gain much in the way of practical experience; 
though an impartial judgment will still pronounce in favour of 
the hospitals, where disease may be seen in much greater variety 
than is possible in the practice of any one man, and where, be- 
sides, the pupil has generally the advantage of instruction from 
men of experience, trained in the art of communicating knowl- 
edge by the bedside. 

I have before referred to the successive examinations in the 
European schools, each examination being as it were a sentinel 
placed at the door of admission into the several higher grades of 
study, and guarding them against intrusion from the incompetent 
pupil. I cannot, however, help believing that these examinations 
are in many instances not very strict, and are employed rather as 
implements of terror to alarm the idle or careless, than as real 
and effective tests of attainment. The same, however, cannot 
be justly said, as a general rule, of the final examination which 
is to determine the fitness of the candidate for the license of the 
doctorate. This is usually performed in public, and invested 
with formalities which may even sometimes impress upon it a 
character of solemnity. In most of the schools we visited, a large 
apartment is appropriated to this special purpose, and is generally 
more elaborately furnished than any other public room in the 
building. Not unfrequently its walls are hung with portraits of 
the deceased professors, perhaps from the origin of the school, 
who may be supposed to be looking down on the proceedings, 
prepared to frown upon any dereliction of duty, that may tend 
to lower the dignity of the school which they had founded or 
adorned. I remember well, at Leyden, having my attention 
especially engaged by the portrait of the famous Boerhaave, 
which hung with many others upon the wall, and both to my- 

21 



322 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

self and my companion recalled strongly the features of our great 
Franklin. In the medical school at St. Petersburg, I was much 
pleased with a method which had been adopted to stimulate the 
student to extraordinary efforts. In the hall of examination, 
which is a magnificent apartment, a large marble tablet has been 
set into the wall, in a conspicuous place, with the names, graven 
in gilt letters, of those candidates who had most distinguished 
themselves from the foundation of the school. There was gen- 
erally one name for each year ; but in some years there were 
two, and in one at least none at all. 

Much importance is attached, in Europe, to the examinations. 
They are almost exclusively relied on as the test of fitness. 
The student, after having inscribed his name upon the cata- 
logue of the school, is left to his own course. He may attend 
what lectures he pleases, or none at all ; but he must, in some 
way or another, qualify himself for answering the interroga- 
tories that may be put to him, whether in the preparatory or 
the final investigation. This, I think, is a defect. A certain 
amount and character of attendance upon the means of instruc- 
tion provided should always be required, without which, ad- 
mission to the examinations should be refused. These are not 
always reliable criteria. The student may be fortuitously ex- 
amined on points with which he may happen to be familiar, 
though generally ignorant; or he may be drilled by persous 
who have made themselves acquainted with the routine of ques- 
tions into which the several examiners are apt to fall, and may 
thus be enabled to answer tolerably with little real knowledge ; 
or, finally, the examiners may, from various interested motives, 
contrive that the candidates shall be successful, however incom- 
petent. If attendance upon lectures be exacted preliminarily to 
the examination, the student will at least have been in the way 
of acquiring knowledge ; and some additional guarantee of fit- 
ness is thus obtained. 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 323 

In some, if not in most of the schools, besides a series of ques- 
tions to be answered, and a theme to be written on, a patient is 
put before the candidate, who is required to investigate the case, 
to make a diagnosis, and to indicate the proper treatment. 
Clinical observation and experience are absolutely necessary 
here to enable the candidate to acquit himself satisfactorily. 

In consequence of the successively advancing steps of instruc- 
tion in European schools, and the long duration of the whole 
course, it happens that the classes of any one teacher are seldom 
large, probably never so large as they often are in some of the 
most successful schools in our own country. I do not think I 
heard of one instance, in which the class exceeded three hundred 
in attendance at the same time on one professor ; 'and this number 
is very rare. Much more frequently it is less than one hundred, 
even in the nourishing schools, where the whole number of ma- 
triculants may be not less than five or six hundred ; and I think 
I have heard of classes consisting of not more than one or two 
listeners. As the pupil is not bound to attend particular lectures, 
he makes a choice among several, and, of course, the most popu- 
lar professors command the largest attendance. It is not always 
the man of highest scientific reputation who has the greatest 
talent of teaching ; and, not unfrequently, they with whose 
names the world resounds are compelled to address their great 
thoughts to empty benches. 

The number of professors is usually large, sometimes a dozen 
or more, and the subjects to be taught are consequently much 
subdivided. This is another reason for the frequently slender 
attendance on the lectures. 

The lecture-rooms are generally small, and poorly furnished, 
even in the most celebrated schools. In the great school of medi- 
cine at Paris, the seats of the chief lecture-room are little more 
than an ascending series of narrow steps, arranged amphithe- 
atrically, from the floor upwards, and I have no doubt are each 



324 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

day trodden by many feet, before they are occupied in the legi- 
timate mode by their ultimate possessors ; and, in the largest 
room I saw at the University of Berlin, the seats of the audi- 
ence were all placed upon the floor, and on the same level with 
that of the lecturer. 

Another remark I made in relation to the lecture-rooms was, 
that the benches frequently exhibited evidence of the use of the 
knife, showing that the whittling propensity is not exclusively 
American ; but I do not remember ever to have noticed an 
adornment of the floors so common in our country, arising from 
the use of tobacco; this luxury being enjoyed in Europe much 
more in the way of smoking than of chewing. 

I was, I confess, surprised at the moderate scale upon which 
the lecture-rooms of the European schools were planned, in 
reference both to size and arrangements. On all the continent, 
I did not meet with an apartment of the kind comparable to 
that in which I am now speaking, however moderate it may 
seem to you. 

In all the schools we visited, the professors receive fixed 
salaries from the government. In some, as in those of Paris 
and St. Petersburg, these salaries constitute the whole emolu- 
ment of the professors, as such ; in others, as that of Berlin, there 
is an additional income from the students, which is proportionate 
to the popularity of the lectures. The latter appears to me the 
best plan of compensation. The professor is secured against 
absolute want by the fixed salary, which is, however, too small 
for his comfortable support, so that he is stimulated to exertion 
in order to supply the deficiency; and this exertion is beneficial 
to the pupil and the school, as well as to himself. I met with 
no instance in which, as with us, the whole compensation of the 
teacher was derived from the students. 

There is probably nothing in which Europe appears to greater 
advantage than in the number and character of the hospitals. 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 325 

This is one of the great triumphs of Christianity, and in itself 
an evidence of the superiority of our holy religion over every 
other faith that now prevails, or ever has prevailed upon the 
earth ; I may say, moreover, a strong argument in favour of its 
divine origin ; for it seems to have been a conception above the 
weakness and selfishness of the natural man, that society owed 
a debt to the poor and the helpless ; and that, instead of tread- 
ing the feeble under foot, in the headlong rush of our passions 
and interests, we are bound to halt in our course, and, at the 
sacrifice of our own pleasures, to support the weak, to heal the 
sick and wounded, and " bind up the broken-hearted." Every 
large city, and very frequently, also, towns of little importance, 
are supplied with one or more hospitals, many of which are on 
a magnificent scale, and conducted in the most admirable man- 
ner. Those of Paris, Vienna, and St. Petersburg more espe- 
cially engaged our attention. If I were called on to decide the 
question of precedence between these hospitals, I should be in- 
clined to say that those of Paris and Vienna accommodate the 
greatest number of patients, while those of St. Petersburg are 
superior in the style of the buildings, and in their interior 
arrangements. Two of the hospitals of that great city are 
peculiarly worthy of notice, that of St. Peter and St. Paul, and 
the General Military Hospital ; the former of which is exclu- 
sively civil, and the latter, as its name implies, exclusively 
destined for the army. The Military Hospital is a vast struc- 
ture of brick, stuccoed, and is completely fire-proof from within 
and without. That of St. Peter and St. Paul is provided, in 
addition to all the usual conveniences, with a broad hall of great 
length, into which the wards open, which is kept perfectly warm 
in the winter, and intended for a place of exercise for the con- 
valescents, who are precluded from exposure to the open air, in 
consequence of the intense coldness of the weather. A pecu- 
liarity of both these hospitals is the connection with them of a 



326 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

slighter building or buildings, admitting of a freer entrance and 
circulation of the external air, into which the patients are trans- 
ferred during the hottest weather of summer. Throughout the 
interior of both, the greatest attention is paid to neatness, clean- 
liness, and the comforts of the inmates ; and, from what I wit- 
nessed of the ordinary condition of the lowest orders of the 
Russian population, I should suppose that they would deem 
admission into one of these establishments as a foretaste of 
Paradise. Yet I owe it to my own country to say that, in all 
Europe, though there were many institutions vastly larger, I 
saw none which, in the propriety, neatness, and I might almost 
say elegance of its interior, surpassed our own Pennsylvania 
Hospital. 

Having heard what I had to tell you on the subject of medical 
education, and the medical institutions of Europe, which might 
readily have been expanded into a volume had time permitted, 
you may perhaps expect to hear something upon the character 
and condition of the profession itself. It would be quite pre- 
sumptuous in me, with the comparatively slender opportunities 
which a rapid journey through the continent afforded me, to 
attempt to give you any very precise or positive information on 
the subject. I may, however, be permitted to state, in a few 
words, the general impressions I have received. 

In the first place, it cannot be doubted that the great mass of 
the physicians and surgeons of the continent consists of men 
well educated, both professionally and otherwise. In both these 
respects, they are probably superior, on the whole, to the medical 
men of our own country. But I must repeat what has been 
already said, that I do not consider them better practitioners. 
In Europe, value is attached to science for itself alone, inde- 
pendently of any practical benefit to accrue from it to mankind. 
This is true of medical science as well as of general knowledge. 
In this country, on the contrary, we seek especially what is 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 327 

practically useful, and that of which the utility can be readily 
appreciated. We are apt to neglect those kinds of knowledge 
which cannot be brought to bear upon the great end of life, that 
of success in the business or profession we may have chosen, 
and give the time, which these would consume in their acquisi- 
tion, to the means of fitting ourselves quickly for entering upon 
our practical career, and afterwards of pushing our fortunes in 
that career as rapidly as possible. This being the general feeling, 
and general practice, individuals who might be disposed other- 
wise, did circumstances permit, are compelled to give way to 
the current. They who amuse themselves with the refinements 
of knowledge, and consume time in storing up facts of no present 
value, will find the paths to success preoccupied by the more 
energetic and practical. In the vast competition, and eager 
haste towards their objects, which characterize the people of 
this country, the votary of pure science, if not independent in his 
circumstances, will feel himself jostled in every direction, and in 
danger of being thrown off by the wayside, if not trodden under 
foot. The remark is not less applicable to the medical than to 
any other profession or pursuit. Hence it is that the American 
physician is the more practical, the European the more scientific. 
The latter understands better the intimate nature of structure, 
and the changes produced by pathological influences, and is 
probably better acquainted with, or at any rate studies more 
profoundly the laws of our physical being as exemplified both 
in health and disease ; but, devoted as he has been to these in- 
vestigations, he gives less attention to therapeutics, is apt to be 
skeptical in everything which rests upon testimony, and turns 
out a comparatively inefficient practitioner. The American, on 
the contrary, is apt to cast a careless eye upon the obscure 
depths where he can see no bottom, passes unheeding by the 
curious and beautiful results of minute investigation, which, 
whatever may hereafter be the case, have yet, as he is disposed to 



328 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

think, yielded no practical fruits, and devotes himself to those 
inquiries by which he can most surely make the sick man well, 
and thereby at once satisfy his conscience and benevolence, and 
secure that good-will and favourable opinion upon which he 
hopes to build his fortunes. In making this contrast, I wish to 
be understood as by no means exclusive. There are a great 
many exceptions on both continents to the general rule, and not 
a few instances in which it is reversed. But I believe there 
really does exist a general difference, such as I have stated, 
between the medical profession of continental Europe and that 
of America ; the former having a greater predilection for the 
abstractions of science, the latter for the practical realities of life, 
and both exhibiting the results of this predilection in their whole 
professional course. 

There is another circumstance which, I think, tends to make 
the American physician, other things being equal, a better prac- 
titioner than the European. In his eagerness for success, the 
former is seldom content with what he learns in the schools, but, 
throughout his whole active life, prosecutes his studies in a 
therapeutical direction, and reads diligently everything upon 
which he can lay his hands having such a bearing ; being im- 
pelled thereto not only by his sense of right, but by the abso- 
lute necessity of not permitting his neighbour to outstrip him in 
the race. The European, on the contrary, is apt to content him- 
self with what he has learned, and makes little comparative effort 
for self-improvement, because he finds all things around him 
moving in fixed courses ; so that, if young, he may await quietly 
the movement w T hich is to advance him ; if old and established, 
may rely with confidence upon the steady order that retains all 
in their due places. Whatever may be thought of the theory in 
this case, the fact is as I have stated. It is proved, I think, 
beyond reasonable doubt, by the vast difference in the sale of 
medical books on the two continents. While in France, or Ger- 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 329 

many, a meritorious medical work may sell at the rate of from 
five hundred to one thousand copies annually; in the United 
States, though with less than two-thirds of the population of 
either of those countries, the sale of a similar work, in the same 
time, will amount to two or three thousand. 

In their social relations, I do not think that the members of 
our profession stand so high relatively on the continent as the 
higher ranks of the physicians and surgeons do in England ; 
and certainly we have the advantage over them in this respect 
in the United States. In France, until a comparatively recent 
date, physicians were upon a footing in general society by no 
means favourable ; and, though the profession has, during the 
present century, been illustrated by many great men, who have 
much elevated their calling in the eyes of the community, yet 
practitioners of a high grade in Paris still eschew their distinc- 
tive title, and use upon their cards the same mode of designation 
as other men. 

Among the Germans, great scientific reputation, or the pro- 
fessorial office, gives a respectable position to medical men as to 
all others ; but I am inclined to think that in itself the profession 
is not specially honoured, though I confess that my means of 
information on this point were limited. 

Upon the whole, it appeared to me that the medical profession 
in Russia, confining the term to the educated class exclusively, 
were upon a better social footing than in any other country of 
continental Europe. This opinion derives much support from 
one interesting fact, which is true of no other country, not even 
our own, where we claim social equality with the highest. In 
the army, which is the most honourable body in Russia, giving 
increased dignity to the nobles, and raising its officers, even those 
of humble birth, to a level with nobility, the surgeons have the 
same rights as the other officers, rising like them through suc- 
cessive grades of rank to the highest, with corresponding emolu- 



330 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

merit. Thus, I knew in St. Petersburg a surgeon of one of the 
regiments of the guards, who, though yet a young man, had the 
rank of colonel ; and Sir James Wylie, who is medical inspector- 
general in the army, has the grade of general in the third degree, 
which, I believe, is equivalent to that of lieutenant-general in the 
British service. 

As another evidence of the position of the profession in Russia, 
I would adduce the fact, that great attention has been paid by 
the government to the subject of medical education. Not less 
than seven schools have been established by law in different 
parts of the empire, all of which are mainly, if not exclusively, 
supported by funds from the imperial treasury. Of these schools 
I had the opportunity of seeing only that of St. Petersburg ; 
but, if the others are to be judged by that example, there is 
assuredly no part of Europe, where more munificent provision 
has been made for the education of those to whom the health of 
the community is intrusted. The Imperial Medico-Chirurgical 
Academy of St. Petersburg, as this establishment is officially 
designated, far exceeds in its visible arrangements any other 
medical school that I have seen. Time is not left us for a detailed 
account of this school; but a few words will serve to give you 
some idea of its character, and consequently of the liberal views 
of its founders and supporters in regard to our science. An 
oblong plot of ground, within the limits of the city, having a large 
front on the river Neva, and extending, I presume, more than 
half a mile in depth, is devoted to the purposes of the institution. 
Within these limits are several large buildings, tw r o of which 
especially are magnificent in extent and proportion. In one of 
these, two vast wings are devoted to the accommodation of three 
hundred young men with gratuitous lodging and boarding ; while 
the central portion is mainly occupied with one great hall, beau- 
tifully finished, which is appropriated to the purposes of a library, 
of public examinations, and of ceremonial observances in con- 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 331 

nection with the school ; and opening into it is a neat chapel for 
the religious services of the establishment. This edifice has its 
front on one of the longer sides of the oblong plot of ground 
before referred to. The second great building, scarcely less mag- 
nificent, presents a beautiful front on the Neva, and forms one 
of the most prominent objects in the view of this part of the city. 
It is occupied by the lecture-rooms, and the various illustrative 
cabinets or collections of the different professors, some of which 
are copious, and all finely displayed in consequence of the ample 
space allotted them. A separate building is appropriated to dis- 
sections j and there are on the ground several low, isolated, 
wooden houses, which are employed for lodging-rooms, during 
the summer, of such of the students as do not take advantage of 
the vacation to scatter themselves over the country. 

Besides all these appliances, there is a very large hospital, 
situated on the opposite side of the grounds to the edifice first 
described, the patients in which, numbering more than a thou- 
sand, are at the disposal of the professors of the school for 
the purposes of clinical illustration in medicine, surgery, and 
obstetrics. 

In addition to the three hundred pupils supported and edu- 
cated within the walls of the establishment, four hundred others, 
who live in various parts of the city, have gratuitous access 
to the courses of instruction, and are admitted to all the advan- 
tages and honours of the school. The only prerequisites to ad- 
mission are that the applicant should be a freeman, and should 
prove himself, on examination, to have had a sufficient pre- 
liminary education. 

The examinations, I was told, are strict ; and, of the seven 
hundred pupils in various stages of instruction, only about 
sixty or seventy graduate annually. The Emperor, who has 
educated them, considers himself entitled to their services ; and, 
after completing their course of study, they enter the army in 



332 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

their medical capacity. This, however, instead of being a hard- 
ship, is a privilege ; placing them at once in a respectable posi- 
tion, and opening a field of indefinite advancement for the future. 

After this favourable view of the medical profession in Russia, 
I should be guilty of injustice did I not call your attention to a 
great man still living, though in the extreme of old age, to 
whom much of the good that I have referred to, with a great 
deal more that I have been unable to notice, is to be ascribed. 
This man is Sir James Wylie, of St. Petersburg. All the medi- 
cal men with whom I conversed upon the subject in Russia 
united in the statement, that the profession in that country 
owed almost everything to him. Withdrawn from active life, 
though still holding some of the highest official dignities, he is 
looked on as a man of the past, and spoken of almost with the 
impartiality of history. We were happy enough to form his 
acquaintance, and to receive various kindnesses at his hands. 
A word from him was sufficient to open the door to us of all 
that it was desirable to see in Russia ; and our verv limited time 
in that country would have been much less profitably employed 
had it not been for his friendly aid. Perhaps it is the grateful 
recollection of his kindness that in some degree prompts me to 
speak of him on this occasion ; but a stronger inducement is 
that I may bring before you the example of one who, by his 
own -merits, has risen from an humble beginning to the summit 
of wealth and honour, and thus stimulate you, now in the very 
opening of your career, to take the steps which he took under 
the same circumstances, and without which he could never have 
risen, and no one can rise to eminence. 

Sir James Wylie was the son of a farmer in Scotland in very 
moderate circumstances. He managed, I know not with what 
aid, to obtain a good education, and to complete a course of 
medical studies in the University of Edinburgh, the honours of 
which school were conferred upon him when he was about 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 333 

twenty-one years of age. Immediately afterwards, in the spirit 
of bold adventure, he sailed for Russia, with nothing to depend 
upon but his own merits, and a determination to use every hon- 
ourable effort to advance himself in the new field he was about 
to enter. He had been extremely diligent in his studies, had 
employed his time to the greatest possible advantage, and now 
went forth confident in himself, and prepared to seize upon and 
make the most of any offered opportunity. As one of my col- 
leagues* said, the other day, in his elegant and truthful sketch 
of our common friend, the late Dr. Horner, f such opportunities 
come to "all men, and the great point is to be prepared to take 
advantage of them. They will come to you, my friends ; and 
whether you shall avail yourselves of them, and, like the two 
men referred to, rise to usefulness, fortune, and eminence, or shall 
let them pass unimproved, and consequently remain in medi- 
ocrity all your lives, or sink into utter insignificance, will in 
great measure depend upon the course you may now adopt. 
Resist, like them, the seductions of idleness and of pleasure ; 
employ all your time sedulously, with a due attention to the 
preservation of health, in the acquisition of professional knowl- 
edge ; avail yourselves to the utmost of the advantages now 
offered to you ; and, having obtained the honours of the school 
to which you may belong, persevere in the same course of self- 
denial, industry, and energetic use of opportunities; and depend 
upon it, should your health and lives be spared, though you may 
not become, like one of these exemplars, professor of anatomy in 
this school, or like the other the friend and counsellor of em- 
perors, and the acknowledged head of the medical profession in 
a great country, you will, each in the sphere of his action, attain 

* Dr. Samuel Jackson, now Emeritus Professor of the Institutes in the 
University. 

f Dr. "Wm. E. Horner, late Professor of Anatomy in the University. 



334 THE MEDICAL PROFESSION IN" CONTINENTAL EUROPE. 

an equally desirable position, with the added consciousness that 
you have performed your parts well in the world, and the rea- 
sonable hope that a happy future may await you when called 
upon to leave it. 

Upon his arrival in St. Petersburg, Dr. TVyle found a field of 
action adapted to his attainments and powers. Having entered 
the army, he soon distinguished himself both as a physician and 
surgeon, and at the end of nine years was employed in both 
these capacities in the imperial family, being especially attached 
to the person of the Grand Duke Alexander, then a young man 
of about twenty-two, whose friendship and entire confidence he 
won, and continued to enjoy after he had become emperor, and 
throughout the life of that distinguished ruler. Thus favoured, 
he advanced rapidly to the highest medical posts in the army, 
and was intrusted at various times with most important func- 
tions in reference to the medical concerns of the empire. He 
was present at most of the great battles fought in that tremen- 
dous struggle which ended in the first overthrow of Xapoleon ; 
and, after the entrance of the allies into Leipsic, had under his 
care at one time, as he himself assured me, 40,000 wounded, as 
well of the French as of the allies, the former having been left on 
the field of battle by Xapoleon. It would be impossible, in the 
brief space allowed me, even to enumerate all the military en- 
gagements in which he participated from 1793, when simply 
surgeon of a regiment, up to 1828, when he attended the army 
in the campaign against Turkey in the highest medical capacity. 
Probably no man living has had under his professional care one- 
quarter of the number of wounded, whom it has been Sir James 
TVylie's lot to superintend. 

The confidence reposed in him by the Emperor Alexander, 
who consulted him on all occasions, enabled him to carry into 
effect the most important measures for the amelioration and 
improvement of the medical institutions, and in general of all 



/ 

THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 335 

that concerned the subject of health, whether in the army or the 
empire at large. He held the high posts of inspector-general of 
the health of the armies, director of the medical department of 
the ministry of war, president of the medical council of the same 
ministry, and president of the Imperial Medico-Chirurgical 
Academies of St. Petersburg and of Moscow. Through these 
positions he could bring his plans to bear upon every department 
of his profession ; and it is reasonable to suppose that the present 
excellent position of the medical officers of the army, the general 
regulations of the medical military service, the very satisfactory 
condition and arrangement of the hospitals, and the superior 
character of medical education as conducted in the schools, have 
all owed much to his sound judgment, enlarged views, and 
almost unexampled opportunities. In his anxiety to produce 
regularity in the pharmacy of the army and the hospitals, he 
prepared a copious pharmacopoeia, composed in the Latin lan- 
guage, which has gone through several editions, and is, I pre- 
sume, of legal authority in the empire. 

Sir James Wylie never relinquished his rights or allegiance 
as a British subject, and, consequently, notwithstanding his 
numerous offices and great influence in Russia, never became a 
subject of the Emperor. He could not, therefore, receive a 
Russian title of nobility, which, under other circumstances, 
would undoubtedly have been at his command. But on the 
occasion of the visit of Alexander to England, George the Fourth, 
then Prince Regent, at the request of the Emperor, conferred on 
him the rank of Baronet, whence he derives the title by which 
he is generally known. Honorary presents and orders have 
been showered upon him, not only by the Russian Emperors, 
but by various other sovereigns; and, if I do not mistake, he 
received from Napoleon the insignia of the Legion of Honour, in 
consequence of his attentions to the wounded French soldiers 
that fell under his care. 



336 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

Sir James was never married. His fortune is immense ; and, 
as I was told in St. Petersburg, he Las made his will, leaving it 
mainly to the Emperor, having, as he says, derived it from the 
favour of the imperial family.* To the members of this family 
he appears to have the attachment of a friend; and he spoke 
with a faltering voice, and tears in his eyes, of the recent decease 
of the Grand Duke Michael, the brother of the present Emperor, 
with whom he seems to have been upon terms of affectionate 
intimacy. 

The greatest merit of Sir James, in my eyes, is the conscien- 
tiousness with which he directed the influence he possessed with 
the Emperor to the elevation of his profession in dignity and 
usefulness, and to the general good of the country in which he 
had taken up his abode. On this account, much more than for 
his wealth and honours, he is held at present in the very highest 
estimation ; and on this basis will rest his fame with posterity, 
who will appreciate in their own advantages the good he has 
done, while they will care nothing for mere personal possessions 
or endowments, w T hich will have perished with the owner. 

In this point, also, my friends, I could wish you to imitate the 
example that I have placed before you. Do not live solely for 
yourselves. Do not seek wealth, station, influence, merely for 
your own personal gratification ; but consider them as means for 
doing good, for spreading benefits around you, and for making 
an impression on the world, which, when you are gone to your 
rewards, will cause grateful recollections to cluster about your 
memory, and your example to be held up to the young for imita- 
tion in all future time. Especially forget not your noble pro- 
fession, and so act and so live as to increase its respectability 

* Sir James died not a great while after our visit, and is said to have 
bequeathed his fortune, as it was presumed that he would do, mainly to 
the Emperor Nicholas. 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 337 

and real worth, and thus render it an instrument of greater and 
greater good, not only to those who may enrol themselves in its 
ranks, but to the whole human family. 

If I have been able to derive, from my recent journey, any 
facts or considerations that may be useful to you now as students, 
or hereafter as practitioners of medicine, and if I have in any 
degree succeeded, according to my wishes, in placing these facts 
and considerations effectively before you, I shall consider the 
result as a great addition to the gratifications of the journey 
itself. Allow me to take an affectionate leave of you for the 
present, with the expression of the sincere hope that, in all our 
future meetings, we may co-operate cordially to the great end of 
our labours here, that of fitting you to become accomplished phy- 
sicians, an honour to the school in which you will have been 
educated, and a source of unalloyed good to those among whom 
your lot may hereafter be cast. 



99, 



ADDRESSES 



TO 



THE MEDICAL GRADUATES 



OF THE 



UNIVERSITY OF PENNSYLVANIA. 



ADDRESSES 



THE MEDICAL GRADUATES. 



Prefatory Remarks. 

Most of my readers, I presume, are familiar with the fact that, in the 
University of Pennsylvania, which has been followed in this respect by 
most of the other medical schools, an address is delivered by one of the 
professors, at the time of the commencement, to the graduating class. 
The three following addresses had their origin in this rule. The first, 
prepared at the special request of the Medical Faculty, is occupied 
chiefly with an account of the history and character of the medical 
department of the University.* In the others, my aim was to impart 
lessons to the young men, which might be useful in their professional 
life. It may, perhaps, be thought by some that the expressions in rela- 

* It was long after the delivery of this address that Dr. Jos. Carson, now Pro- 
fessor of Materia Medica in the University, prepared and published his elaborate 
history of the Medical Department of the School. To that work I have pleasure 
in directing the attention of any reader who may desire to inquire further into 
the subject. For fulness and accuracy of detail, it is all that can be desired. — 
Note to the second edition, Feb. 1872. 

(341) 



342 ADDRESSES TO THE MEDICAL GRADUATES. 

tion to quackery, employed in these addresses, and in some of the pre- 
ceding lectures, are unnecessarily strong ; but they convey my real 
sentiments ; and it must be remembered that they were addressed to 
students, or recent graduates, with the view, not of exciting hostility 
against irregular practitioners individually, but of guarding the young 
men themselves against the possibility of falling into an empirical 
course, by placing its degradation in true and strong colours before 
them. I have always, too, endeavoured to make a distinction between 
the irregular practitioners who have a more or less full faith in what 
they profess, and those who act against better knowledge, with the sole 
view of making money, no matter at what cost to those whom they de- 
ceive- Any self-appropriation, therefore, of language referring to the 
latter set of practitioners, must be received as a confession of member- 
ship in the class ; and I presume that there are few honest persons, of 
any profession, who would not admit the justice of the severest possible 
expressions of censure in such a case. 






ADDRESS I. 



DELIVERED AT THE MEDICAL COMMENCEMENT, HELD MARCH 26th, 1836. 



Sketch of the History of the Medical Department of the 
University of Pennsylvania. 

Gentlemen : — 

It is by the appointment of the Medical Faculty of the Uni- 
versity, that I now have the honour of addressing you. I 
should be proud, on any occasion, of acting as their representa- 
tive ; I am peculiarly so on the present, when the object is to 
welcome your entrance into the ranks of our profession. Allow 
me, on behalf of my colleagues, as well as for myself, to express 
a cordial sympathy with you in this most important era of your 
lives. We participate in the satisfaction of your retrospective 
view ; in the delight of your present relaxation from toil and 
anxiety ; in the buoyant gladness of your new independence ; 
in the lofty aspiration, the hope, the confidence, the joy of your 
eager glance into the future. We have the whole picture of 
your emotions indelibly traced upon our memory. In our sym- 
pathy with you, we live over again one of the happiest and 
most exciting moments of our own existence. Our congratula- 
tions, therefore, are not the mere expressions of cold formality; 
they are the overflowings of a real participation in your feel- 
ings, and of a sincere interest in your welfare. 

(343) 



344 HISTORY OF THE MEDICAL DEPARTMENT 

It is true that the relations which we have hitherto borne 
towards each other are dissolved. You have grown in knowl- 
edge beyond the need of our assistance, and are about to take 
your flight into the world of action, each trusting to his own 
strength, and selectiug his own course, in the broad expanse be- 
fore him. But. though we can aid you no longer, our earnest 
wishes for your true good will follow you always. One part- 
ing word of counsel, dictated by these wishes, will be received 
in the same spirit of kindness in which it is given. Let it enter 
deeply into your convictions, that your success in life will de- 
pend mainly on yourselves. Trust nothing to fortune, or to the 
fancied advantages of your position. Labour diligently, in your 
intervals of leisure, to render yourselves more competent to the 
performance of your professional duties ; guard your sentiments 
and conduct so as to command the respect of honourable men ; 
and endeavour to cultivate such an exterior deportment, as may 
render your presence not unacceptable to those into whose 
society you may be thrown. Thus accomplished, if you watch 
diligently the current of affairs, neither imprudently rushing 
into the midst of adverse events, nor allowing any favourable 
opportunity for honourable action to pass unimproved, you will 
as certainly prosper in the world, as the seed, sown in a good 
soil., and nurtured with due care, will spring up and ripen into 
harvest. The moral world is governed by laws not less uni- 
form in their operation than those which regulate the physical. 
Much less is justly ascribable to accident than men are usually 
disposed to imagine. The successful often feel a pleasure in 
considering themselves the favourites of fortune; while the un- 
successful are always willing to shift off from their own folly or 
carelessness the responsibility of their failure. But there are 
few men so purely fortunate as to be unable to point to some 
prudent forethought, or wise decision, or prompt action, as the 
real origin of their success; and perhaps not one wretched man 



OF THE UNIVERSITY OF PENNSYLVANIA. 345 

exists, who cannot recall numerous instances, in his experience, 
of time misspent and opportunities neglected. With this maxim 
always before you, that } r ou must rely upon yourselves, and 
with the stern resolution to leave no honourable means un- 
tried of promoting your advancement, you cannot fail to at- 
tain, if not the pinnacle of your ambition, at least a respectable 
station in life, with a competent provision against all ordinary 
mischances. 

But, gentlemen, your attention will not be occupied exclusively 
with your own worldly prospects. You will not compress the 
whole current of your soul within the narrow and turbid channel 
of selfishness. By a wise ordinance of Providence, the exercise 
of an expanded benevolence is not incompatible with our true 
interests. If it turns away the thoughts for a moment from 
schemes of profit or ambition, it more than repays the loss by its 
cheering effect upon the heart, and its ennobling influence on the 
character. The overflow of kindly feeling, at the same time that 
it enriches the soil upon w T hich it spreads, clarifies and sweetens 
the stream from which it proceeds, and to which it returns again. 
If actuated, therefore, by no higher motive than a regard for our 
own happiness, w T e should cultivate good-will for others, multiply 
friendly relations with objects around us, and throw out in all 
directions the cords of endearing association, by which we may 
reciprocally draw and impart refreshing sympathy and useful 
support. 

Among the moral associations which are least tinctured with 
selfishness, and therefore tend most to elevate and refine our 
nature, are those which continue to connect the pupil with his 
preceptors, after the immediate tie between them has been 
severed, and he has been borne by the current of time and events 
far away into some new scene of action. I cannot doubt that 
you feel at this moment, in some measure, the force of such asso- 
ciations. You will probably feel it more, when the trivial pains 



346 HISTORY OF THE MEDICAL DEPARTMENT 

and anxieties which have intermingled with your recent labours 
shall have faded from your memory, leaving only the recollection 
of benefits received, strengthened by daily increasing experience 
of their value. Often, hereafter, you will throw back your 
thoughts from the turmoil of business into the quiet scenes of 
your professional study. The familiar countenances of your 
preceptors will then rise, with renewed freshness, before your 
memory. You will dwell with feelings approaching to those of 
filial affection upon their efforts to interest and instruct you ; at 
once to inspire you with a taste for knowledge, and to furnish 
the means of its gratification ; to prepare you. in fine, so far as 
in them lay, for the high duties to which you are destined, and 
the noble reward to which the performance of these duties will 
entitle you. 

The school in which you were instructed will share in these 
feelings of affection. In the warmth of your imaginations you 
will inspire its corporate existence with the attributes of real 
life, will interweave into its character your conjoined estimate 
of all its teachers, and will love it as the centre of numerous 
pleasing recollections, the witness of your earnest labours and 
ultimate success. In order that you may know it more thor- 
oughly, may appreciate its real deserts, and may thus be 
enabled to render it an enlightened support in the struggle of 
competition in which it is engaged, I propose to lay before you, 
on this occasion, a brief account of its origin, progress, and 
present condition. I can, perhaps, do this with greater pro- 
priety than my older colleagues ; as, from the shortness of the 
period during which I have been officially connected with it, I 
cannot be supposed to appropriate to myself personally any of 
the credit which may be found to belong to the school. 

The first conception of a plan for establishing a medical school 
in this country appears to have been formed by Dr. William 
Shippen and Dr. John Morgan, both native Americans, while 



OF THE UNIVERSITY OF PENNSYLVANIA. 347 

prosecuting their studies in Europe. If it be desirable to live in 
the memory of those who may come after us, the names of these 
gentlemen occupy a most enviable position. Placed at the 
source of a stream which must continue to flow on through 
ages, they will be a point of search for future inquirers while 
civilization lasts. Hundreds of men of brilliant endowments, 
after filling the ears of their contemporaries with their renown, 
and by the impetus of their great minds forcing themselves far 
into the memory of posterity, will, in the course of time, drop 
one by one into oblivion until all are forgotten. But the future 
historian, though, in threading his way through the past, he may 
sweep multitudes of once great names as rubbish from his path, 
must at least preserve those which stand at the. commencement 
of any great course of action. The fame of Shippen and Morgan 
will, therefore, continue to be cherished in this country, so long 
as its inhabitants shall be subject to physical infirmities, and the 
healing art be deemed worthy of cultivation. 

So early as the year 1762, Dr. Shippen, in the introductory to 
a private course of lectures on anatomy, announced his belief in 
the expediency and practicability of founding a medical school 
in Philadelphia. In 1765, Dr. Morgan, upon his return from 
Europe, laid before the trustees of the College of Philadelphia, 
which had then been in existence as a collegiate establishment 
about ten years, a plan for the institution of medical professor- 
ships in connection with the seminary under their direction. The 
plan, which came strongly recommended by several influential 
friends of the College in England, was adopted by the trustees, 
who immediately appointed Dr. Morgan to the chair of the 
theory and practice of physic. In the same year, Dr. Shippen 
was chosen professor of anatomy and surgery. For a short 
time, lectures were delivered by these two professors on the 
various branches of science, then deemed essential in a course 
of medical instruction. In 1767, a system of rules w T as adopted 



348 HISTORY OF THE MEDICAL DEPARTMENT 

for the organization of the new school ; in 1768, Dr. Adam Knhn 
was appointed professor of materia medica and botany, and Dr. 
Thomas Bond of clinical medicine; and. on the 21st of June, 
1768, a medical commencement was held for the first time in 
America, at which the degree of Bachelor of Medicine was con- 
ferred upon ten individuals. The chair of chemistry was added 
in H69, and was filled by the appointment of Dr. Benjamin 
Rush. 

Such, gentlemen, was the germ of that school, which has been 
so long scattering its fruit over every part of our vast country, 
and under whose broad shade we are now assembled, more than 
seventy years from its origin, to celebrate the return of its 
annual season of productiveness. Not less than three genera- 
tions have partaken of its benefits ; for, in the catalogue of its 
first graduates, is the name of the grandfather of a young gentle- 
man who now most worthily receives its honours, and whose 
father was also a graduate of the school.* It is beginning to be 
venerable in the eyes of men ; for it is associated with the gray 
hairs of their fathers. But age, which has given it dignity, has 
taken nothing from its strength : and it still stands erect and 
prominent among the numerous offspring which have risen up 
around it. Its growth at first was not rapid. Humble in its 
original organization, it gradually expanded with the increasing 
wants and resources of the country, and thus acquired a solidity 
and permanence which it would have failed to attain, if forced 
by injudicious management into a precocious increase. 

* Dr. Wm. Elmer, now a highly respectable practitioner of Bridgeton, 
Cumberland County, New Jersey. His father, of the same name, was 
also a graduate of the medical department ; and his grandfather, Dr. 
Jonathan Elmer, at one time Senator of the United States from New 
Jersey, was, as mentioned in the text, a member of the first graduating 
class. 



OF THE UNIVERSITY OF PENNSYLVANIA. 349 

In the year 1769, when the Medical Faculty was fully formed, 
it consisted, strictly speaking, of only four professors ; for the 
chair of clinical medicine appears to have been little more than 
nominal, and was abolished after the death of Dr. Bond. You 
will easily understand how imperfect must have been the courses 
of instruction, when the three branches of anatomy, surgery, and 
obstetrics were taught by one professor. With this deficient 
organization the school continued till 1782, when botany was 
separated from materia medica, and erected into a distinct pro- 
fessorship. 

In the mean time, however, a great change had taken place in 
the government of the College. In the violence of political ex- 
citement, its charter had been abrogated by the State legislature, 
and all its rights and property transferred to a new institution, 
which was dignified with the title of University of Pennsylvania. 
But this event, which took place in the year 17 79, does not 
appear to have affected the Medical Faculty, which continued, in 
the new school, to be constituted in the same manner as in the 
old. In 1789, ten years after the act of abrogation, the legis- 
lature, admitting its injustice and illegality, restored to the Col- 
lege, by a new act, all its former privileges and possessions ; 
so that two institutions now existed, distinguished by the titles 
of the College and the University. The Medical Faculty was 
thus, for a time, thrown into disorder, one portion attaching 
itself to the old school, and another to the new ; and some modi- 
fications were made in the arrangement of the professorships, 
which, however, as they were of short duration, do not appear 
to merit particular notice. Happily, the two institutions were 
soon afterwards reunited by a voluntary agreement, which re- 
ceived the sanction of law ; and an opportunity was thus af- 
forded, in the year 1791, for a new organization of the medical 
school. 

Six professorships were now recognized, under the titles re- 



350 HISTORY OF THE MEDICAL DEPARTMENT 

speetively of 1. anatomy, surgery, and midwifery, 2. theory and 
practice of medicine, 3. institutes and clinical medicine, 4. chem- 
istry, 5. materia niedica, and 6. botany and natural history. But 
this arrangement was dictated by the necessity of combining 
two faculties, and supplying places for the members of both, 
rather than by a sense of its general propriety. Hence, the 
chair of the institutes and clinical medicine was afterwards 
united to that of the theory and practice ; and the chair of 
botany and natural history ceased to be considered essential, 
when the opportunity was offered of transferring its occupant to 
that of materia medica. 

In the year 1805, a great improvement was made by the estab- 
lishment of a chair of surgery, and another scarcely less import- 
ant, in 1810, by the separation of obstetrics from anatomy, and 
its elevation to the dignity of a distinct professorship. From the 
latter period no material change took place in the organization 
of the school, until, by a recent regulation, the institutes were 
again separated from the practice, and placed upon an equal 
footing with the other important branches. 

From this hasty sketch you may perceive that the school has 
been gradually expanding from the time of its foundation ; and 
that at no former period has it presented an organization, so 
nearly in accordance with the just demands of medical science, 
as at this very moment.* 

It would be a pleasing task to go up with you again to its 
origin, to introduce you to a more intimate acquaintance with 
its founders, and then, descending along the course of its history, 
to make you familiar with each of the great names successively 
that have illustrated its various departments. But the attempt 

* 1 would call attention again to the date at which this address was de- 
livered ; in the spring, namely, of 1836 ; at the end of the first course of 
lectures delivered by myself in the school. 



OF THE UNIVERSITY OF PENNSYLVANIA. 351 

would be vain to compress so many merits within a space so 
short as we could now allot to them. Perhaps, moreover, the 
task would be useless. What name is there among* the worthies 
who elevated and sustained this medical school, that is not in 
the memories and the mouths of all who have any pride of pro- 
fession ? What medical man, who has at heart the honour of his 
country, is ignorant of the names of Rush, Barton, Wistar, and 
Physick, not to mention others, both dead and living-, who have 
been associated with these great men in their labours and their 
fame ? With two only of those I have mentioned has it been 
my good fortune to have any personal intercourse. One of these 
is now beyond the reach of human applause or censure ; and the 
other stands so high in personal dignity, fortune, and the respect 
of men, and is so far removed from the business and agitations 
of ordinary life, that sentiments of admiration may be allowed 
ample scope in their expression, without affording ground for 
dishonourable imputations. You will excuse me if I yield for a 
moment to the impulse of my feelings, and throw in my mite of 
tribute to their deserts. 

The name of Wistar must have called up a train of affectionate 
and touching remembrances in the minds of many who are now 
present. They can recall the affable and courteous manner, the 
heart full of kindness, the tear for distress, the cordial smile of 
sympathy or welcome, the open band, the generous, noble spirit 
that shone in every feature, and spoke in every act. They can 
picture him in their imagination, as he formerly stood in his lec- 
ture-room, full of his subject, inspiring into all the interest which 
he felt himself, unravelling intricacies and lighting up obscurities 
by an almost magic touch, with a countenance beaming with in- 
telligence and affection ; himself the centre of a love and respect 
which amounted almost to reverence. I might speak of his gen- 
eral knowledge, his scientific attainments, his professional skill, 
the large space which he filled in the society and business of the 



352 HISTORY OF THE MEDICAL DEPARTMENT 

city, the esteem in which he was held in all parts of the Union. 
I might dwell also on that sensitive delicacy of conscience which 
he exhibited on all occasions, whether as a teacher considering 
himself answerable for the ignorance of his pupils, as a judge decid- 
ing upon their claims to a recognition of their capacity to practise, 
or as a physician, lavish of his time, attention, and labour upon 
the sick, without reference to their ability to afford him pecuniary 
compensation, and perhaps without a thought upon the subject. 
But even an outline of the qualities of his heart, mind, and con- 
duct, would extend beyond the limits which I could here devote 
to them ; nor do I feel myself adequate to their just representa- 
tion. The sketch I have attempted is but a faint copy of the 
vivid impression, which must be stamped on the memory of all 
who knew him. It is far from doing justice to my own recol- 
lections of his rich and beautiful character. 

Not less impossible do I find it to embody in words the senti- 
ments of respect which are entertained by myself, in common, I 
am sure, with the whole of this audience, towards another illus- 
trious supporter of the school, the last survivor of those upon 
whom its fame w T as built, and now looked up to as the acknowl- 
edged patriarch and head of the medical profession in this coun- 
try. I need not mention the name of Physick. There is but 
one man in the Union to whom all would concede this pre-emi- 
nence. Who is there in this assembly, in this city, I might say, 
w r hat intelligent man in the country, who is not familiar with his 
admirable skill in operative surgery, and with the numerous im- 
provements which the art owes to his genius ? What medical 
man, who has had the opportunity of professional intercourse with 
him, is unacquainted with those high qualities w T hich have placed 
him at the head of American practitioners? his keen insight into 
disease, united with the spirit of minute and patient inquiry ; his 
inexhaustible copiousness of expedient ; his undaunted resolu- 
tion, which never wavered under a sense of personal accounta- 



OP THE UNIVERSITY OP PENNSYLVANIA. 353 

bility; his persevering adhesiveness to an approved plan, alike 
against the remonstrances of the patient, the discouragement of 
medical associates, and the weariness of his own disappointed 
expectations. Hundreds are now living who owe life or limb to 
the exercise of these rare qualities, under circumstances which 
would have apparently justified despair. Consider him as a 
man, without reference to his professional merits. What dignity 
of character and deportment ! what scrupulous regard for the 
just claims of others ! what perfect self-command ! — qualities 
which have placed their possessor upon an unassailable eminence, 
and have precluded the least show of disrespect unless from 
audacity itself. But it was, perhaps, in the lecture-room that 
Dr. Physick appeared to most advantage. Those of us who 
have listened to his instructions in surgery can well remember 
how impressive was the dignity and earnestness of his manner, 
how clear and forcible his flow of fact and illustration. We can 
recall the absorbed attention, the profound respect approaching 
almost to awe, which sat habitually upon the countenance of the 
class ; we can recall too the delightful emotion, the almost elec- 
tical thrill of pleasure, which flashed through every breast, when 
his features relaxed, during the relation of some pleasing inci- 
dent, from their usual earnest sobriety into the bright cheerful- 
ness of a smile. With the title of Emeritus Professor of Sur- 
gery and Anatomy, Dr. Physick still lends to the school the 
influence of his great name, though prevented by feeble health 
from an active participation in its affairs. Long may the evening 
of his days continue to shed its mild radiance upon our walls! 
Long may he live to fill a place in the profession, in which he 
can have no successor !* 



* The following note was addressed to the author by Dr. Physick a few 
days after the delivery of the lecture. It will be readily conceived that 
it was received with great pleasure, the greater, perhaps, because wholly 

23 



354 HISTORY OF THE MEDICAL DEPARTMENT 

The school has in general been fortunate in enjoying, through 
a long series of years, the services of those among its teachers 
who were best able to advance its interests. One striking ex- 
ception, however, is afforded in the instance of the highly gifted 
Dorsey,* whose meteor course was suddenly quenched in death 
at the moment of its greatest splendour. He lived, however, 
long enough to add one flower at least to the wreath of fame 
which encircles the history of the institution, and to prove that, 
had life been spared to him, he would have earned for himself a 
place in the memory of men, scarcely less elevated than any now 
filled by his predecessors. 

Devveesf also had a professorial career too short for the good 

unexpected. It should be remembered that I was a comparatively young 

man at the time. 

Phila., 6th April, 1836. 
Dear Sir, 

I did not receive a copy of your address lately delivered to the medical 
graduates in the University of Pennsylvania until last evening, when I 
had the pleasure of finding that you had mentioned my name with the 
most gratifying approbation. 

For the honour of this notice, and for the kind feelings evinced in the 
manner of it, allow me to express my warmest acknowledgments. 

I remain, dear sir, most respectfully and sincerely your friend and 

servant, 

P. S. PHTSICK. 
To George B. Wood, M.D., 

Prof. Mat. Med. in the University of Penna., etc. 

* Dr. John Syng Dorsey, chosen first as the adjunct of Dr. Physick in 
the Chair of Surgery, afterwards as successor to Dr. Chapman in that of 
Materia Medica, and finally, upon the decease of Dr. "Wistar, in the year 
1818, as Professor of Anatomy. He had, however, but just entered upon 
the duties of the last-mentioned oflice, when he was cut off by death ; so 
that he never delivered a course of anatomical lectures. 

f Dr. Wm. P. Dewees, who was appointed, in 1825, adjunct to Dr. 
Thos. C. James in the professorship of Obstetrics, and became full pro- 



OF THE UNIVERSITY OF PENNSYLVANIA. 355 

of the school, though sufficient to connect his name indissolubly 
with its history, and to entitle it to claim his ample honours as 
among its own brightest ornaments. It is no mean boast of the 
institution to have ranked among its officers the man to whom 
all agree in assigning the highest place among American obste- 
tricians, whether in relation to practical skill, to merits as an 
author, or to diffused reputation both at home and abroad. Of 
his kind and amiable nature, his unaffected simplicity of char- 
acter, his cultivated taste for the fine arts, even of his abilities 
as a teacher, I do not intend to speak. They are too well known 
to you all to require any comment from me. The affecting tes- 
timony of friendship and esteem spontaneously offered him by 
the class, on the eve of his departure for a foreign land, must be 
still fresh in your memory. What a noble scene was your last 
meeting with your venerable preceptor ! I can still see him 
seated in the midst of the assembled throng, in the very scene 
of his former labours, enfeebled alike by disease and by the 
crowd of emotions which pressed upon him ; come to receive 
your parting token of affection, and to bid farewell alike to you, 
and to the place in which he had so often before met you in the 
full vigour of his powers. Every breast was filled with sym- 
pathy, every eye was moist with compassion ; a deep silence 
evinced the absorbing interest of the scene ; and when the last 
thanks and the last blessings, which his feeble lips were unable 
to pronounce, were read by a mutual friend, one common feeling 
of sadness and solemnity overshadowed the assembly, and one 
common prayer went up from the deepest recesses of the heart, 
that the remaining path of his life might be smooth, and the 
evening of his days unclouded and serene. 

fessor in 1834, on the resignation of Dr. James. He was seized with 
paralysis, as he was about to enter upon his course, in the autumn of 
1835; and, being unable to make himself heard by the class, resigned the 
professorship. 



356 HISTORY OP THE MEDICAL DEPARTMENT 

In these brief sketches, I have not pretended to offer a history 
of the Medical Faculty from its first institution. In such a his- 
tory, it would be unpardonable to pass over names, which on the 
present occasion have not been mentioned, or to give a subor- 
dinate place to others which have been merely alluded to. My 
object has been, in the utter impossibility of presenting a com- 
plete picture, to touch off simply some points which were prom- 
inent in my own experience or recollection, and to which, there- 
fore, however imperfectly executed in other respects, I have at 
least been able to give the impress of truth. 

Before the present audience, it would be superfluous to speak 
of the general prosperity of the school. It may be interesting, 
however, to trace its gradually increasing success, as indicated 
bv the number of those who received its honours, at different 
periods, from its foundation to the present time. 

I have already stated that the number of graduates, at the 
first public commencement in 1768, amounted to ten. This was 
exceeded only on three occasions during the remainder of the 
century, on one of which, in the year 1197, the graduating class 
consisted of fifteen. The average annual number from the origin 
of the school to the year 1800 was only seven. From this 
period it appears to have rapidly increased. In 1810, the 
annual list of graduates had swollen to sixty-five, in 1819, to 
one hundred and two, and in 1831, when it attained its maxi- 
mum, to one hundred and fifty-one. Dividing the present cen- 
tury up to 1830 into periods of ten years, we find that the 
average number yearly in the first period was about thirty- 
three, in the second seventy-one, and in the third one hundred 
and seven, and since 1830, it has been one hundred and thirty- 
two.* But the number of graduates is not an exact criterion of 

* From 1830 to the present date, a.d. 1859, the average number of 
graduates has been 154. The highest number was in the session of 



OP THE UNIVERSITY OF PENNSYLVANIA. 35 1 

the relative prosperity of the school at different periods; for, 
from a combination of various circumstances, it has happened 
that the proportion of those who have annually received the 
honours of the institution to those who have merely attended 
upon its courses of instruction, has been gradually augmented 
during the latter years of its existence ; so that its early success 
was in fact greater than might be inferred from the statement 
just made. 

Originally, two degrees in medicine were conferred, corre- 
sponding with those in the arts. The prerequisites to the lower 
degree, or that of Bachelor of Medicine, were the possession of 
a competent knowledge of the Latin language, mathematics, and 
natural philosophy, the serving of a sufficient apprenticeship 
with some respectable practitioner of medicine, a general knowl- 
edge of pharmacy, and an attendance upon at least one complete 
course of lectures, and upon the practice of the hospital for one 
year. The higher degree, or that of Doctor of Medicine, was 
conferred on the Bachelor at the expiration of three years, upon 
the conditions that he should have attained the age of twenty- 
four, that he should write a thesis, and should publicly defend 
this thesis in the College. This system was found inconvenient 
in practice, and, as it was productive of no counterbalancing 
advantage, was abandoned for that now in operation, upon the 
union of the schools in 1791. The regulation formerly existed, 
that the thesis of the successful candidates should be published ; 
but this too has been very properly abandoned, as an unneces- 
sary impediment in the way of graduation. 

We have thus, gentlemen, taken a rapid glance at the past 

1848-9, when it amounted to 190; the matriculating class of the preced- 
ing session, that of 1847-8, having numbered 509, the largest in the 
records of the school, up to the present winter, when it is exceeded. — 
Note to the first edition, Dec. 1859. 



358 HISTORY OF THE MEDICAL DEPARTMENT 

history of the medical school whose honours you now receive. 
May I ask your further indulgence, for a few minutes, while I 
attempt to represent to you the advantages of its present position, 
and the claims which it advances to a continuance of the sup- 
port which it has hitherto both merited and received ? I am 
sure you know me too well to suppose, that, in thus assuming 
the office of its advocate, I am actuated by any sordid views of 
personal profit. I wish you also to understand, that, in the 
remarks which follow, the Faculty of the University have not 
the least disposition to undervalue the merits of the numerous 
sister institutions throughout the country. A race is before us ; 
a noble prize is to be won ; we hail every honourable competitor 
with a friendly spirit. The very excitement of a fair and open 
contest is equivalent almost to the pleasure of victory. Let 
each school present its advantages in the strongest light, and 
exert its own strength to the utmost, leaving to its neighbour 
the same privilege unmolested ; and, whichever may maintain ' 
precedence in the struggle, no just or honourable spirit will 
complain. 

Not the least among the advantages of this school are those 
connected with its locality. The city of Philadelphia, centrally 
situated in regard to latitude, far enough from the ocean for per- 
fect security, yet not so distant as to be of inconvenient access 
from abroad, sufficiently populous to insure ample opportunities 
for anatomical and clinical illustration, well supplied with libra- 
ries and cabinets of specimens, salubrious as a place of residence, 
and richly furnished with all the necessaries and comforts of life, 
is peculiarly adapted to become the resort of medical students, 
and the focus of medical instruction for the whole Union. 

Another advantage of the University, and one peculiarly its 
own, is its relative antiquity, and the number of great names 
connected with it in the capacity of teachers or of pupils. The 
principle of association by which we appropriate to ourselves a 



OF THE UNIVERSITY OP PENNSYLVANIA. 359 

portion of the credit or censure attached to any cause, or set of 
men, or institution with which we are connected, a principle 
rooted in the very foundations of our nature, and the source of 
some of the noblest feelings with which it is adorned, extends in 
its influence not less to the past than the present. Who does 
not experience a glow of satisfaction at the mention of the virtues 
or praiseworthy deeds of his forefathers? Who does not glory 
in the former honours of his country? Is there one of you, 
gentlemen, who does not value his degree the higher, as pro- 
ceeding from the oldest medical sckool of this continent, as con- 
necting him with the illustrious names of those who raised it 
into fame, as ranking him in that band of three thousand gradu- 
ates which embraces so large a portion of the medical reputation 
of our country for the last seventy years ? Is it not something 
to have frequented the same halls in which your fathers were 
initiated into the profession, to go out to the contest under the 
'same flag under which they triumphed ? These are not fugitive 
or barren associations. They will attend you through life ; they 
will intermingle in your whole course of medical duty; they will 
elevate your tone of professional feeling, and serve as a light 
and guard to your path when beset with doubts and temptations. 
Your eyes will be constantly directed to the bright examples of 
those into whose fellowship you have been admitted ; and, 
while spurred on by an honourable emulation to imitate their 
course, you will feel an additional obligation to avoid any dis- 
graceful act, lest it may in some measure sully their fair fame. 
There is, therefore, something more than the mere gratification 
of feeling; there is positive benefit in a connection with the age 
and reputation of the Universit}^; and few, I will venture to say, 
have ever repented the choice which led them to this connection. 
But do not imagine that I recur to the past from any conscious- 
ness of present weakness. The University has not yet arrived 
at the period, when it will be compelled to resort to its hoarded 



360 HISTORY OF THE MEDICAL DEPARTMENT 

capital of reputation. If success be accepted as a criterion of 
merit, it can still boast, amidst the powerful efforts of numerous 
rivals, a degree of support, not inferior, upon the average of a 
few years, to that which it enjoyed when it stood comparatively 
alone. It cannot be denied, that the new institutions which 
have struck their roots deeply into the soil once exclusively its 
own, have drawn off much nutriment that would otherwise have 
contributed to its further expansion ; but, though thus checked 
in its growth, it has lost none of its ample proportions, and still 
throws out its undiminished limbs, the pride and boast of this 
continent. If it be judged by the character of its fruit, it has 
still less of which to be ashamed. Search for the rising profes- 
:al merit of this country, the budding of future professional 
reputation ; where will you find it if not among the pupils of this 
school ? When did classes ever proceed from its walls, more 
rife with the seeds of honour and usefulness to their country than 
those of the last few years ? 

Consider now the organization of the school. Has it not been 
advancing with the general march of improvement, and is it not 
at this moment more perfect than at any former period ? You 
are all aware of the addition of a new and most important pro- 
fessorship, that of the institutes, made before the commencement 
of the late session. What school in the Union can boast at 
present of so extensive a course of instruction ? Little more is 
wanting to render its organization entirely equal to the present 
advanced state of medical science, so far, at least, as accords 
with the institutions and habits of our country. But it has been 
deemed safest to proceed cautiously with changes ; to allow the 
new work to become consolidated by time, before venturing upon 
further additions. In the mean while, the attention of the 
Faculty has been directed towards the improvement of the 
several courses which enter into its present plan ; and as one of 
the means of such improvement, they have now under considera- 



OF THE UNIVERSITY OF PENNSYLVANIA. 361 

tion the propriety of extending the winter session to five months, 
thereby relieving the pupil, and at the same time affording scope 
for more ample instruction. 

The resources in possession of the school for the illustration 
of the various demonstrative lectures, have accumulated beyond 
all example in this country. The chemical apparatus is probably 
inferior in variet} r , splendour, and costliness to none in the 
world. The anatomical museum, commenced by Dr. Wistar, 
has been augmented by the indefatigable industry of the present 
professor to an extent which leaves little to be desired. You 
can all bear witness to its richness in every variety of specimen, 
drawing, and model which can serve to illustrate the obscurities 
of anatomical structure ; and it would be impossible anywhere 
out of Europe to find an equal collection of pathological speci- 
mens. Surgery also is illustrated in every mode of which the 
subject is susceptible ; and the magnified drawings connected 
with this branch, independently of their merit as pictorial repre- 
sentations, are worthy of notice as specimens of art. The same 
spirit of improvement has been carried into the obstetrical chair; 
and you have been presented, during the last winter, with illus- 
trations in this department such as have never before been wit- 
nessed in our school. It does not become me to speak upon the 
subject of materia medica. I may, however, be permitted to 
say, that my object has been to place this among the demon- 
strative branches ; and that, if I have failed to render the subject 
interesting and impressive, it has been from deficient ability, not 
from the want of assiduity in providing the requisite means. 

It is unnecessary to call your attention to the ample accom- 
modations of the present hall for every department of medical 
instruction. Among its recommendations, not the least is the 
opportunity afforded by its open precincts for free ventilation, 
and the consequent prevention of that injurious influence upon 



S*:2 HISTORY OF THE MEDICAL DEPARTMENT 

the health which always results from the confined air of close 
and crowded apartment 

Tiir system of clinical instruction, which, in its present form, 
owes its origin to the professors of this school, has been carried 
to a perfection before unknown in the United States. By the 
ample arrangements of the two hospitals, particularly of that 
attached to the Philadelphia Almshouse, it has been found possi- 
ble to afford the advantages of practical illustration in medicine 
and surgery to the largest classes ; and you must all be sensible, 
from your experience during the past winter, of the benefits 
which flow from this mode of instruction. 

To com pie fee a view of the present condition of the school, it 
would be requisite to portray the qualifications of the several 
profess he but upon this subject I am not permitted to speak. 
Were I to express all that I think in relation to my colleagues, I 
should incur the suspicion of being influenced by the partiality 
of interest r of friendship. This much, however, may be said, 
that one common feeling animates all the Faculty ; a disposition 
? sc far as lies in their power, the usefulness of the 
school, and a determination to exert, to the utmost, whatever 
abilities they possess, to render their courses instructive and 
interesting to the pupil, and honourable to the institution. 

I have addressed you on the subject of the school, without 
reserve. By the possession of its honours, you have become, in 
some measure, partners in its fame. Sympathizing with those 
who have its prosperity at heart, and disposed to participate 
cordially in the furtherance of their honourable views, you have 
a right to all the information which it is in our power to com- 
municate. The Faculty rely on your good-will. They leave 
their cause confidently in your hands ; and I am much mistaken 
in the nature of those feelings which serve as the bond between 
you and them, if they will ever have occasion to repent the trust. 

You are now about to leave us, in order to enter upon the 



OF THE UNIVERSITY OP PENNSYLVANIA. 363 

active business of life. I see a varied scene before you ; but 
hope at present sheds her bright sunshine over all. I would not 
damp by one word the ardour of your young wishes, or the warm 
energy of your resolves. I would not repress, if I could, that 
eagle gaze into the future, which pierces through cloud and 
storm, to fix upon the bright sun beyond. The loftier your aim, 
the more vigorous and sustained will be your flight, and the 
higher your ascent into the fortunes and honours of this world. 
But there is one point of the utmost importance to your happi- 
ness, wherever your course may lie, whether high or low, in 
light or obscurity, among abundance or want ; a strict observ- 
ance of the rules of honour and morality. Without this, your 
greatest success will be nothing more than a- splendid failure. 
A secret consciousness will poison every pleasure, mingle a 
sense of disgrace in every triumph, and darken the whole soul, 
even amidst the sunniest fortunes. With it, on the contrary, 
scarcely any condition can be absolutely desperate. The storms 
of adversity will never find you without a cloak to protect, nor 
the fiercest assaults of grief without a solace to comfort you. 
But, while such are the advantages of an upright life in the 
lowest extreme of fortune, it very seldom happens that they who 
adhere to it have occasion to invoke its consolations under such 
unhappy circumstances. The scriptural declaration, " never 
have I seen the righteous forsaken," is but the expression of a 
general law of nature. The exercise of a conscientious guard 
over our propensities to evil, will be found an almost certain 
road to respect and confidence ; and, united to a spirit of enter- 
prise and the habit of industry, will prove a powerful instru- 
ment of elevation to the highest stations attainable in well- 
regulated communities. In your pursuit, therefore, of fame and 
fortune, never lose sight of this polar star. Turn not to the 
right or the left at the bright but delusive promise of the meteor 
lights which will entice you. In the path of your ambition, if 



364 MEDICAL DEPARTMENT OP THE UNIVERSITY OP PA. 

duty or honour place but a straw in your way, pass not regard- 
less by, but remove it before venturing to proceed. 

We feel a deep interest in your honour and success ; we point 
to the path in which you may almost surely prosper ; and if, in 
this parting moment, our wishes and admonitions assume a 
character of solemnity, it is in accordance with the occasion ; 
the last of our meeting together, after a long and satisfactory 
intercourse. Yes, gentlemen, it is a solemn occasion. In thus 
parting forever, we stand, as it were, upon the brink of eternity; 
and our thoughts irresistibly rise up to that power which rules 
the vast obscure into which we are about to enter. If, weak and 
faulty as we are, we may venture to approach the pure majesty 
of His presence, we would earnestly ask for those who are about 
to embark upon the untried ocean of active life, a long course of 
virtuous prosperity; a career full of happiness to themselves, 
and of blessings to their fellow-men. Gentlemen, farewell. 



ADDRESS II. 



DELIVERED TO THE GRADUATING CLASS AT THE COMMENCEMENT 
HELD APRIL Into, 1841, 



Gentlemen :— 

In compliance with custom, and with the dictates of their own 
feelings, your teachers propose to address to you a few words of 
congratulation, of counsel, and of good wishes, before they and 
you part, never to meet again in the same relation. We have 
endeavoured, to the best of our ability, to aid you in preparing 
for the duties upon which you are about to enter ; we have care- 
fully and solicitously examined your qualifications for these 
duties ; and we have had pride in presenting you to the authori- 
ties of this school as meriting its formal testimonial in your 
favour. That testimonial you have received in the degree of 
Doctor of Medicine which has just been conferred upon you. 
We congratulate you upon your honourable entrance into the 
ranks of our profession, and gladly offer you the hand of fellow- 
ship. But we shall not have fully discharged our obligation, 
without adding to the lessons you have already received some 
hints out of the stores of our experience, which may be found 
useful in the long and arduous course of life you this day com- 
mence. 

You have gained one great requisite to success ; a good start- 
ing-point from which to throw yourselves forward into the future. 
With the aid of your teachers, you have risen above the obstruc- 

(365) 



366 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

tions which impede every attempted flight from the surface, and 
have reached a spot in the ascent of knowledge, whence enter- 
prise may boldly spread her wings in the air, and be assured of 
support. But it would be a great mistake to content yourselves 
with this advantage. No error is more fatal to the young physi- 
cian, than the notion that the period of study is passed, and that 
hereafter he has only to act. To sustain a vigorous advance, it 
is necessary that, to the store of intellectual strength which he 
has accumulated in youth, he should make incessant additions 
at every stage of his progress. His ascent, unlike that of the 
projectile whose velocity diminishes constantly as the original 
impulse upon which it depends is exhausted, should rather re- 
semble the flight of the eagle, who draws in new strength with 
every inspiration, and mounts steadily towards his goal. The 
knowledge which you have acquired should be considered only 
as a key to the vast storehouse whose riches are now open to 
you. If you aspire after excellence in your profession, merited 
success in life, and an honourable distinction ; and there is 
probably not one among you who does not cherish such aspira- 
tions ; you will look upon the present merely as a period of 
holiday relaxation, to be followed by renewed labour in the at- 
tainment of medical knowledge. 

It is not probable that your time will for some years be quite 
absorbed in practical duties. The course of things, in this 
world, is much better ordered than if left to our own wishes, 
which, in the eagerness of pursuit, would leap over all obsta- 
cles, and if possible annihilate time and space. Existence, under 
our own guidance, would be nothing more than a rapid succes- 
sion of wish and fruition ; a thunder-storm in the night, with its 
flashes and its peals, and darkness between. We should lose 
the gentle excitement of alternate hope and fear, the pleasingly 
changeful sunshine and shadow of the landscape of life. We 
should lose the sweet reward of mental and bodily toil ; the 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 367 

sense of enjoyment, namely, which Providence kindly mingles 
with the cup of labour which he gives to all men to drink. We 
should lose, moreover, those luxurious intervals of repose, when, 
seated beneath our own arbour, at our own household door, with 
all that is most dear about us, we look out upon the green, the 
blossoms, and the fruits, and feel that they are all ours, and that 
we have earned them. Be assured, gentlemen, that rapid and 
unearned success in life is not desirable. It is well, therefore, in 
reference merely to your own good, not to speak of the good of 
others, that you should have further time for preparation ; that 
the practical business of your profession should come gradually, 
so that while your circle of duties is widening, you may have 
the opportunity of extending equally that of your qualifications. 
You may ask for instruction as to the course of study best 
calculated to advance you in the knowledge of your profession. 
In the first place, it is highly important that you should pro- 
ceed with system. Desultory medical reading may furnish you 
with a mass of rich materials ; but they will be irregularly 
heaped together in your memory, and mingled, moreover, with 
much that is merely rubbish ; so that, in answering the demands 
of practical emergencies, you may ransack your store in vain 
for the desired object, and, in your haste and confusion, will 
even be liable to draw forth for use something wholly inapplica- 
ble to the end proposed. There is, moreover, in this sort of 
reading a dissipation which, as in every other pursuit, whether 
mental or physical, enervates the faculties which are called into 
play, and, if long indulged, unfits for any steady and laborious 
effort. In your medical studies, therefore, we would advise you 
to fix upon some systematic course, beginning with those ele- 
mentary subjects which lie at the basis of the science, and, in 
your progress upwards, endeavouring always to master first 
those points in the ascent, the possession of which will facilitate 
your attainment of something higher. 



368 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

But our science includes several distinct practical departments, 
in all of which it is scarcely possible for any one individual to 
attain great proficiency. We may err almost as much by perse- 
veringly endeavouring to carry more than our arms will hold, as 
by being content with less. The greedy little child, who, un- 
willing to relinquish any portion of the desirable things within 
his reach, finds one thing after another falling from his arms as 
fast as he fills them, and at last, after repeated efforts, lets them 
all drop and begins to cry, is but the miniature of the ambitious 
student who wishes to learn everything, and, failing in the at- 
tempt, gives up in despair, and abandons study altogether. The 
best course is that each one should consult his peculiar turn of 
mind, and, as far as possible, his capacity, and give a corre- 
sponding direction to his studies. In medicine, a certain degree 
of acquaintance with all the branches is desirable, and to one 
whose sphere of action may lie in the country, is indispensable ; 
but special skill is attainable only by a concentration of effort ; 
and he who wishes to excel should push his investigations pre- 
ferably along some one route, though he may profitably cast 
his eye over the neighbouring tracts as he proceeds, and may 
occasionally diverge so as to get a general view of the whole 
region. 

The steady pursuance, however, of a certain course of study 
should not prevent you from paying a particular attention to 
those forms of disease which may happen to come under your 
notice. We always read more intelligently, and better remem- 
ber what we read, when the object of study is before us. When- 
ever, therefore, a case may occur to you, upon which you may 
be conscious of insufficient information, suspend for a time your 
regular plan, until you have investigated, in relation to the com- 
plaint, all the authorities within your reach. Such interrup- 
tions, though they may break the continuity of the stratum of 
your studies, will, like cross-veins of some precious metal, 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 369 

greatly enhance their value. In exploring your memory for re- 
sources in any case of difficulty, you will find these deposits at 
once most obvious to your researches, and most productive of 
the aid you seek for. 

I cannot leave this subject, without again endeavouring to im- 
press upon you the importance of devoting the early years of 
your practical life to the continued prosecution of your medical 
studies. The physician who considers his degree as a dispensa- 
tion from future intellectual labour, and henceforward looks only 
to the fruits of his profession, will be apt to reap but a scanty 
harvest ; or, even should fortune cast his lot on some rich prairie 
soil, which yields abundantly to a very careless culture, he will 
find himself unprepared to gather in the abundant crop, which 
may thus perish upon his hands. It will be in vain, when he 
begins to experience the want of more ample professional re- 
sources ; when he finds the magic stream which he has set in 
motion by an accidentally discovered word, flowing in upon him, 
and threatening to overwhelm him, because unprovided with 
that other word which would enable him to control its move- 
ments ; it will be in vain, at this late period, that he may strive 
to repair the consequences of early neglect, and seek safety for 
his reputation, and peace for his conscience, by a late pilgrimage 
to the shrine of science. Knowledge, like the fabled Roman 
sibyl, makes the offer of her treasures once, twice, thrice, on 
each successive occasion diminishing the amount offered, and at 
length threatening to withhold all if her last offer is rejected. 
As we advance in life, we find it impossible to break through 
the crust, which early neglect may have allowed to gather 
around our faculties, and which has become hardened by habit. 
It is only by a constant expansion that, like the young growing 
shellfish, the intellect can prevent that concretion which is ever 
disposed to form about it, from becoming so firm as to restrain 
all future increase. A neglect of your early opportunities will 

24 



3*70 AN ADDRESS TO THE MEDICAL GRADUATING CLA5> 

prove in great measure irreparable, when time and experience 
shall bring with them a due sense of their importance. On the 
contrary, by cultivating assiduously those opportunities, you 
will find your knowledge growing with the growing demands 
upon it ; you will experience a happy harmony between your 
avocations and your capacity; aud, when in the full career of 
business, with the life and temporal happiness of great numbers 
in your keeping, though you may feel sensibly the deficiencies 
even of the highest knowledge, you will at least escape the 
ever-present and ever-gnawing consciousness, that your capa- 
bilities are not only beneath the level of your times, but also far 
beneath what nature and opportunity would have enabled them 
to become. 

The point, perhaps, next in importance to the acquisition of a 
due store of medical knowledge and skill, is the cultivation of a 
proper professional spirit. This is to the physician the very soul 
of his occupation, which, without it, would be a mere lifeless in- 
strument for the supply of his necessities, a dead compost to 
quicken and nourish the crop of his sordid enjoyments. He who 
considers his profession as an avenue to nothing higher than 
pecuniary gains, and limits his efforts accordingly, will find his 
capacity, and, unless under strong religious influences, his con- 
science also dwindling to the measure of his views. Next to an 
ever-present feeling of responsibility to a higher power, there is 
no principle so influential in promoting every liberal and useful 
effort, in restraining every irregular or sordid act, in giving a 
high tone at ODce to sentiment and conduct, as a true professional 
spirit, which looks beyond personal profit to the respectability, 
honour, dignity, and general usefulness of a calling. 

But this principle should not be confounded with the esprit de 
corps, which is nothing more than a sort of cohesive affinity be- 
tween the constituent particles of an aggregate body, a selfish 
principle which yields for the sake of receiving support, which 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 371 

has no reference to the aims of the mass which it actuates, and 
is quite as efficient for evil as for good. The true professional 
spirit forgets the individual in the great objects of the profession ; 
the esprit de corps thinks of the calling only from its connec- 
tion with the individual. The former can exist only where there 
is something great, or noble, or useful to support it, and breathes 
most freely in a pure atmosphere ; the latter lives as well on 
garbage as on luxuries, and finds a congenial air wherever there 
is a crowd. The esprit de corps requires no cultivation. It 
springs up spontaneously in the soil of association, and flourishes 
vigorously upon the passions, the interests, and the selfish 
calculations which are everywhere abundant. The true profes- 
sional spirit, on the contrary, is a delicate plant, which is de- 
veloped only under the warmth of generous feeling, requires the 
careful nurture of good principles and dispositions, and is in 
constant danger of being choked by the sordid growth around it. 
But then it is exceedingly sweet and beautiful ; and its fruit is 
honour to the profession and benefit to mankind. 

This feeling naturally arises in a well-constituted mind, upon 
the perception of an elevated character, and of noble and benefi- 
cent objects in the profession to which it is attached. Let us 
examine how far the profession of medicine offers such claims to 
the devotion of those who have enlisted themselves under its 
banner. You will surrender yourselves with a more complete 
and more hearty self-abandonment to the service of your new 
mistress, should she be found worthy at once of your highest 
esteem and your warmest affection. 

In estimating the character of a profession, we should consider 
the nature of the qualifications required for its due exercise, the 
end towards which it is directed, and the influence it is calculated 
to exert upon its votaries. Deficiency in any one of these re- 
spects would be a serious drawback to its merits ; while excel- 
lence in all would give it a claim to the very highest considera- 



372 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

tion. A few* words on each point will serve to indicate the 
proper position of our profession. 

I know of no calling which requires a wider extent of knowl- 
edge for its due exercise. The study of medicine considers man 
both physically and morally, both in a healthy and diseased state, 
and in all those relations which have any bearing upon the sound- 
ness of his body or mind. It goes out into exterior nature, and 
investigates intimately every agent which has the power to pro- 
duce, to prevent, to cure, or to alleviate disease. It inquires into 
the mutual action and reaction of bodies, and into the changes 
in nature, form, or position resulting therefrom, so far at least 
as these circumstances are connected with the functions of the 
human system, the operation of exterior agencies upon that sys- 
tem, or the modification of such agencies by natural or artificial 
causes. Anatomy, physiology, pathology, psychology, botany, 
mineralogy, zoology, chemistry, and natural philosophy, are but 
a portion of the sciences which contribute to the constitution, or 
themselves form a part of the complex science of medicine. The 
accomplished physician is also expected to have some acquaint- 
ance with the languages of Greece and Rome ; and, if he wish to 
avail himself of all the resources within his reach, must cultivate 
also those modern languages, such as the French and German, 
which are the most frequent vehicles of new medical thoughts, 
facts, and disquisitions. As a gentleman, moreover, associating 
intimately with the best instructed and most polished members 
of the community, he should be more or less conversant with 
polite learning, and familiar with the various topics of the day, 
whether literary, scientific, or political. 

But knowledge is not his only essential qualification. He 
should possess, in addition, a practical skill derived from a close 
personal observation of disease, and of the application and effects 
of remedies. He should have the graces of a gentlemanly de- 
portment, and familiarity with the conventional forms of good 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 373 

breeding; so that he may avoid wounding the often morbid 
delicacy of his patients, and adding the irritations of an offended 
taste, or ruffled temper, to the evils of the disease. He should 
be endowed, in an eminent degree, with the qualities of a good 
heart, rectitude of principle, and firmness of purpose; for in no 
profession are the temptations to a relaxation in the performance 
of duty stronger ; and in none are the consequences of such re- 
laxation so fatal to comfort and happiness in this world. I need 
scarcely say, in fine, that a good, native intellectual basis, is 
essentially requisite for the erection of that superstructure of 
knowledge which is expected of every physician ; and that the 
faculties of a quick perception, good judgment, and accurate 
reason, are indispensable to a just solution of -the intricate pro- 
blems, which disease frequently presents both in its nature and 
mode of cure. It is a great mistake to select medicine as a sort 
of hiding-place for deficient intellect ; for, though a solemn ex- 
terior may for a time impose upon the public, it cannot long con- 
ceal the vacancy within from penetrating eyes ; and the mischief 
which may have accrued, in the mean time, is incalculable and 
irremediable. 

Such, then, are the qualifications in knowledge and character 
which the accomplished physician brings into the practice of his 
profession. Let us inquire whether the objects for which he em- 
ploys them are of equivalent importance. These objects are the 
preservation of life, and the restoration and maintenance of 
health. JSTone, certainly, can be of higher value in reference to 
this world alone. But the mere mention of them produces little 
impression. When life first opened upon us, there seemed about 
it a holiness, like that of the ark, which it was sacrilege to touch. 
We shrank with a shuddering fearfulness from the thought of its 
extinction ; and the word which spoke of our mortality, thrilled 
through us like a summons to judgment. Language was then a 
true picture of reality. But we have subsequently heard so 



374 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

much of life, death, and futurity, that our sensibility to the 
awful import of these sounds has become exhausted. Like the 
oft-repeated tolling of the church bell in our vicinity, they fall 
upon our ears, but we do not hear them. We are told of the 
value of life, and readily admit the fact ; but it makes no im- 
pression, and we turn away to some indifferent object. We 
acknowledge the great importance of the profession whose busi- 
ness it is to save life ; but we do not feel it. To realize its im- 
portance we must be, or imagine ourselves, in a situation to 
require its aid. Let this touchstone be applied to the profes- 
sion of medicine. 

Suppose yourselves upon a sick-bed, in the crisis of a very 
dangerous disease, with the full consciousness of your condition. 
You look through the portals of eternity, and view an awful 
obscurity before you. The past, with its joys and its troubles 
which now seem joys, its hopes and fears, its host of things done 
and undone, its certain faults and doubtful virtues, whirls through 
your recollection like a long dream of enchantment, from which 
you are about to awake into some dread reality. The sweet 
affections of this world entwine about your retreating form, and 
strive to hold you. Connubial and kindred love cling with fond 
arms around you, and with tears entreat you not to desert them. 
But an irresistible force seems to impel you onward. You are 
on the brink of the abyss ; a dizzy mist comes over your senses ; 
you are on the point of falling. But the eye of professional skill 
is watching over you, and, at the moment of despair, an arm is 
extended to save you. With its support and guidance you 
return to life and health ; and, oh ! what joys attend your path. 
How beautiful is every object ; how balmy the air ; how delicious 
the fragrance ; how sweet the music around you ! Nature springs 
with radiant smiles and extended arms to meet you. Every 
sense appears to have been baptized into a new and exquisite 
susceptibility of enjoyment. Life and its affairs have acquired 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 375 

new interest to your regenerated feelings. Your bosom swells 
with kindly emotion towards every animated thing ; and your 
thoughts ascend, from the midst of the temple of your enjoyment, 
with deep humility and ardent thankfulness, to the author of all. 
This is no fictitious picture. Thousands and tens of thousands 
are realizing it every day. 

But it is not our own lives only, with all their renewed enjoy- 
ments, that we sometimes owe, under Providence, to the skill of 
the physician. We are often in want of the same aid for those 
most dear to us. There are many present, I have no doubt, who 
have sat by the bedside of some near relative in alarming illness, 
watching with anxious eye each movement of the patient, fearful 
that every breath might be the last, and longing, with a scarcely 
repressible impatience, for the approach of him upon whom every 
earthly hope depended. And when at last the physician came, 
with what trembling eagerness was he greeted ! How intensely 
did the strained eye scan his features, to gather from their ex- 
pression the message of hope or despair ! What relief, what joy, 
when the inquiring gaze was answered by a smile of encourage- 
ment and confidence ! How did the heart overflow with grati- 
tude for that kind watchfulness, that unwearied attention, that 
skill, which had brought the tempest-tossed bark, laden with so 
many hopes, once more to a safe haven ! It is in such moments 
as these that we feel the full value of medical services. 

Even when the efforts of the physician are unsuccessful, there 
is a priceless consolation to the survivors in the reflection, that 
nothing has been left undone which skill could accomplish. The 
practitioner, indeed, often finds, with some surprise, that his 
warmest and firmest friends are those who have lost some dear 
relative under his care. His kind attentions are indissolubly 
associated with the memory of the dead ; and no petty feeling 
of self-love, which too often endeavours to lighten a burdensome 
sense of obligation by undervaluing the favours received, can, 



3*76 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

in this instance, mar the first impression of affectionate grati- 
tude. 

Were our profession unable to prolong life, were its only 
service to shorten and alleviate disease, and render life more 
comfortable, it would still be the instrument of great benefit to 
mankind. How often do we see pains almost beyond human 
endurance, which extort groans and even cries from the strong 
man, retiring at the command of the physician, and leaving the 
patient, to use a frequent expression of his own, in a heaven of 
relief! How often are the discomfort and unfitness for any 
useful exertion, which have been running through months of 
some chronic malady, cut short in a few days, or in a few weeks, 
by medical interference ! Not to speak of the immense mass 
which is thus, in the aggregate, taken off from the load of human 
wretchedness, the contribution which is made to the productive- 
ness of human industry, in all its forms, by augmenting the time 
and capacity for labour, is altogether incalculable. Not only, 
therefore, does our profession accomplish its own immediate ends 
of preserving life and health, with all their abundant blessings, 
but it indirectly also promotes the ends of every other profession, 
by augmenting the agency through which these ends are attained. 

It yet remains to inquire what are the influences of our pro- 
fession upon its own members. At the very threshold of this 
inquiry we are met by two notions, to a certain degree prevalent, 
that the study of medicine disposes to infidelity, and its practice 
to disputation and strife. That there have been many unbe- 
lievers among physicians, and that public attention has been 
occasionally called to our disputes, is not denied. But of what 
profession or pursuit in life cannot the same be said ? The chief 
cause of our peculiar reputation in these respects, is probably the 
circumstance that we are distinguished by a peculiar designation, 
which reflects more or less upon the whole class the credit or 
discredit of each individual. If a lawyer, a soldier, a merchant, 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 3TT 

or a gentleman without profession, should happen to be an un- 
believer, or should be so unfortunate as to quarrel with his 
neighbour, the imputation rests with himself, and no one thinks 
of inquiring to which of these several classes of men he belongs, 
much less of fixing his fault or his misfortune upon his calling. 
But if a physician fall into the same predicament, his title of 
doctor directs the public attention at once to the great body of 
doctors, and we are compelled to pay for the very doubtful honour 
of our distinctive designation, the very extravagant price of 
public odium. Nay, the faults and follies of those who bear the 
same title as ourselves, without belonging to us, go to swell the 
charges against our profession ; and I doubt not that, by many, 
the crimes of the late notorious Dr. Francia himself are laid at 
our door. The truth is that, among physicians as among other 
men, there are believers and unbelievers ; and that, as other 
men, we occasionally differ among ourselves, and are so unwise 
as to bring our differences before the public; but that there is 
any peculiar tendency in the profession to either of these results, 
is altogether a mistake. On the contrary, the natural tendency 
of medical studies, by bringing before the mind innumerable 
instances of the wisest and most benevolent design, is to im- 
press strongly upon the conviction the existence and attributes 
of Deity; and, at least within the circle of my own observation, 
a remarkable harmony prevails in the profession, even in 
instances where there is an apparent opposition of interests. 

It scarcely consists with the occasion to enter into a philo- 
sophical disquisition upon the influences of profession in the 
formation of character ; otherwise it would not be difficult to 
prove, that each practical pursuit has a tendency to stamp its 
own peculiarities, in a greater or less degree, upon the indi- 
vidual ; so that, if the course of study be comprehensive and 
liberal, and the course of action nobly directed, the intellectual 
and moral character will be in a corresponding degree expanded 



3*78 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

and elevated. Now, it has been shown that the study of medi- 
cine covers a vast tract of human knowledge ; and it may be said 
to join, by an indefinite boundary, many of those departments 
which do not absolutely fall within its limits. It has been 
shown, also, that its practice is directed to the noblest results of 
human pursuit, short only of those which are to be found in a 
future existence. If, then, there be truth in human reason, the 
general character of the profession, wherever circumstances 
admit of its legitimate and full development, should be at once 
liberal and exalted, embracing a wide expanse of diversified 
interest, and elevated above mean and sordid views and calcula- 
tions. And are not the deductions of reason justified by observa- 
tion ? In those countries where medicine has been duly culti- 
vated, do we not find physicians prominent among the competitors 
for honour in almost every branch of literature and science ? 
Are not their names enrolled, in large proportion, in the cata- 
logue of every learned society ? Is there a feasible project of 
public usefulness which does not receive their support ? Is there 
a charity to which they do not contribute largely out of their 
comparatively slender means, and still more largely by their 
services, professionally and otherwise ? Most assuredly there is 
no profession which gives up more of its time, and labours more 
assiduously, without reference to pecuniary compensation, than 
the medical. Endowed by its very constitution with peculiar 
faculties for the relief of human misery, it is impelled to the 
exercise of these faculties whenever occasion offers, and is thrown, 
almost by the necessity of the case, into a course of benevolent 
action. I presume that I am rather falling short of the truth 
than exceeding it, when I state my impression, that at least one- 
half of the time and service devoted by physicians to practical 
professional pursuits, at all events in large cities, is entirely gra- 
tuitous. It is indeed a question whether this disregard of their 
pecuniary interests is not carried by physicians to the very verge 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 379 

of injustice ; whether they have not so long accustomed the 
public to expect gratuitous service, that it has at length come 
to be considered as a right ; whether, in fine, the readiness, I 
had almost said eagerness, with which they seize upon every 
opportunity for the charitable exercise of their skill, has not pro- 
duced a general impression that, on all such occasions, they, and 
not the public, are the favoured party. 

Nor is it only in the prompt surrender of their time and efforts 
at each call of duty, irrespective of all direct emolument, that 
physicians illustrate the generous and liberal spirit of their pro- 
fession. In the ordinary avocations of life, a useful invention or 
discovery is considered as a just title to peculiar emolument ; 
and no one hesitates to avail himself of the law which secures 
to him, for a limited period, the exclusive control of the new 
source of profit which he has created. But it is not so with 
physicians. The results of their labour and genius, whether 
new views of disease, new remedies, or new processes of cure, 
though years, nay a lifetime of labour and research may have 
been devoted to their discovery and elaboration, are unhesita- 
tingly thrown into the lap of the profession, and made the com- 
mon property of all. It is considered altogether unprofessional 
to keep secret, with a view to pecuniary advantage, any valuable 
remedy; and few regular physicians or surgeons have deigned 
to resort to the protection of the patent law. The only legiti- 
mate advantages to the individual, according to the strictest 
professional code, are the credit of the discovery, the consequent 
probable increase of profitable occupation, and the heartfelt 
satisfaction attendant upon the consciousness of having con- 
tributed to the honour of the profession, and to the general 
good. 

Such, gentlemen, in its character and tendencies, is the pro- 
fession to which you now belong. It is a profession of which 
you may well be proud ; affording scope for the exercise of your 



380 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

best faculties and affections ; tending by its noble purposes to 
elevate you above all that is low and sordid ; and making you 
the honoured instruments of the greatest earthly good to your 
fellow-men. Open your hearts, gentlemen, to the spirit which 
it would breathe into you, and cherish this spirit, like a sacred 
fire, by the vestal ministration of your highest and purest feel- 
ings. Commingled with your moral sense, it will shed a bright 
light about your steps, which in the darkest period of tempta- 
tion will enable you to keep in the true path of honour and use- 
fulness. Before this light, the phosphorescent splendour which 
often beautifies corruption itself will fade away, and you will 
see the rottenness as it really is. The glittering exterior of dis- 
honourable success, which so often reflects the images of proud 
triumph to the eyes of the multitude, will be found a mere tinsel 
cover to self-reproach and conscious degradation. What if, under 
a system of false pretension, of unworthy contrivance, of tor- 
tuous policy winding itself into every opening however foul and 
crooked, a physician should attain a certain amount of tempo- 
rary success ; what if, in opposition to better knowledge, he 
should trim his sail to some popular breeze, and, raising the flag 
of homoeopathy, Thompsonism, or some other folly of the day, 
should glide out of the obscurity, in which he may hitherto have 
been concealed, into a short-lived notoriety; what if, abandon- 
ing all regard to decent appearance, he should hang out the 
meretricious allurements of the vender of secret nostrums, and 
gather wealth and splendour by the wages of his professional 
prostitution ; is all the success, or ten times the success which 
he may meet with in the world, the slightest remuneration for 
that self-loathing with which he must look into his own corrupt 
interior, for that pity or scorn with which he is conscious that 
he is regarded by his former professional brethren, and by the 
most enlightened individuals of the community which he dis- 
graces ? But I wish not to be misunderstood. It is only those 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 381 

who sin against better knowledge that are here referred to. 
Conscientious convictions should be respected, even though based 
upon ignorance and delusion ; and, so prone is the human intel- 
lect to every kind of aberration, that we may readily admit the 
possibility of an honest conversion from orthodoxy in medicine 
to the wildest creed that ever sprang from a deluded imagination. 
We can even suppose that an educated physician may become 
a convert to some Mormonism in medicine, and, under the 
scourge of public contempt, feel all the consolations of a martyr. 
For such delusions there should be no other feeling than com- 
passion, as there is no other cure than time. That the public 
should suffer is a misfortune ; but this is equally the result of 
ignorance and delusion on their part, and is probably one of the 
means, in the wise course of Providence, for the eradication of 
error, and the ultimate diffusion of light and truth. 

Imbued with the true spirit of the profession, you will be 
elevated above all these sources of error in conduct and judg- 
ment. In shaping your own course, you will always have 
reference to the honour of your calling, which, as it is based 
upon truth, and aims only at the good of mankind, will, in your 
relations with one another, with your patients, and with the 
w T orld, have a tendency to keep you within those great ethical 
rules which have the same origin and object. Under this influ- 
ence, you will, in every doubtful case, ask yourselves the ques- 
tion, whether the proposed course will conduce to peace and 
harmony among physicians, to the welfare of those intrusted to 
your charge, to the general good of society, and to the due esti- 
mation and consequent influence of your profession among men ; 
and, according as this question is answered affirmatively or 
negatively, you will unhesitatingly advance or recede, even 
though your apparent immediate interests may suggest a dif- 
ferent conduct. Nor, in the end, will you ever have occasion to 
repent the seeming sacrifice. The instances are few, indeed, in 



382 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

which perseverance in a strictly honourable professional course, 
with a due degree of enterprise and industry, has not led to 
ultimate success ; while, in our voyage through life, we are con- 
stantly passing the wrecks of hopes once as fair as our own, 
stranded upon the shoals of temporary interest and disreputable 
expedient. 

We have thus, gentlemen, in taking our last farewell of you as 
a body, endeavoured to leave with you, as a parting gift, some 
thoughts for your professional guidance, which I have no doubt 
will be received in the same kindly spirit in which they are 
offered. It gives us great pleasure to present you, in addition, 
with the acknowledgment of our entire satisfaction with your 
deportment and exertions during the past winter, and with the 
general success which has crowned your efforts. From the 
peculiar relations of our school towards the country, and to- 
wards the sister schools which have sprung up everywhere in 
such rapid succession, it has happened that a progressive im- 
provement has been observable in the classes of graduates who 
have annually left our walls ; and I am authorized by my col- 
leagues to say, as their united sentiment, that the present class 
constitutes no exception to the general rule. We have, indeed, 
been exceedingly gratified by the result of the recent examina- 
tions, which, though assuredly not less rigorous than those of 
preceding years, have evinced a degree of preparedness on the 
part of the candidates, which has been equalled on no former 
occasion within our recollection. "We send you forth, therefore, 
with entire confidence that your future course will be creditable 
to yourselves, and to the institution whose honours you bear. 
It is scarcely necessary to say that, wherever you go, you will 
carry with you our warmest sympathies. "We have a personal 
interest in your conduct and success. Scattered over every part 
of the country, you will be the standard by which men will 
judge of the merits of the school in which you were instructed ; 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 383 

and we are willing to abide the test. Whether your present 
grade of character and professional attainment, or the position 
you are hereafter to occupy, be regarded as the criterion, we 
are willing to rest our claims to public approval upon the result 
of an impartial judgment. Perhaps, the very consideration that 
the reputation of your ala mater is in some measure in your 
hands, may add a generous and effective impulse to the other 
motives which urge you onward in the course of honourable 
exertion. There is no purer source of satisfaction, in this world, 
than so to stand in the eyes of men as to reflect back honour 
upon those to whom we have been in any degree indebted for 
early culture. 

But, gentlemen, we must bid you farewell. Crowds of thoughts 
and emotions press upon us at this moment of separation, which 
time is wanting to express. We must content ourselves with 
referring to your own good sense for all of counsel, and to your 
own hearts for all of feeling that we are compelled to leave un- 
told. May the divine blessing attend you throughout this life, 
and follow you in the life to come. 



ADDRESS III. 



DELIVERED TO THE GRADUATING CLASS AT THE COMMENCEMENT, 
HELD MARCH 29th, 1856. 



Gentlemen : — 

Your state of pupilage is now passed ; and, by the solemn 
act just performed, you have been admitted into full membership 
in the great medical body. We, your late teachers, congratulate 
you on this fulfilment of your wishes, and receive you heartily 
into professional brotherhood. Custom, as well as our own feel- 
ings, prompts, along with the most kindly greetings upon the 
occasion, a few words of friendly suggestion, such as age and 
experience, and an interest scarcely less than parental, may 
perhaps be admitted to warrant. 

But first we have the pleasing duty to perform, of awarding 
to merit its just meed of commendation. The Faculty are united 
in the statement, that with no class which has ever assembled, 
under their tuition, have they had better reason to be satisfied, 
whether in relation to general demeanour, or industrious appli- 
cation to study. For some years, it has seemed to them that, in 
both these respects, a gradual advancement in successive classes 
has been observable ; and the present assuredly affords no ex- 
ample of retrogression. It is due to the students of medicine 
who now annually flock to our city, that we should perform our 
part towards placing them erect, as they deserve to be, in public 
(384) 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 385 

opinion. There is, perhaps, still lurking in our community some 
residue of that old prejudice, if prejudice it was, which regarded 
the young devotee of medicine as a little given to wildness ; as 
disposed to qualify the sobriety of his daily routine by an occa- 
sional effervescence of conduct, not strictly in accordance with 
the rules of law and good order. Now, whatever may have been 
the truth in relation to past times, I do most sincerely express the 
conviction, that the students of the present day are characterized 
by a regard for the proprieties of life, even beyond what is gen- 
erally observable of young men of the same age ; and that an 
equal number of any other calling whatever, not bound by pe- 
culiar religious obligations, collected under the same circum- 
stances of freedom from restraint, would offer more frequent 
occasion than they for complaints of irregularities, and various 
indecorums. The very nature of their position has led to this 
result. With the increase of professional competition, and the 
widening of the circle of medical knowledge, there has been an 
increased necessity for exertion ; and the student feels that, to 
secure the attainment of his objects, he must work more, and 
amuse himself less than his predecessors. That he does labour 
diligently; that the scholastic hall and the quiet chamber are- 
more familiar to his experience than the theatre and the bar- 
room ; that his feasting is mainly at the board of knowledge,, 
and his intemperance that of study and not the bowl ; are suffi- 
ciently evinced by the contrast between what he is in face and 
person when he arrives, and what he becomes before departing. 
With this contrast I have often been struck. Fresh from active 
pursuits, he comes ruddy or embrowned, full of health, spirit, and 
physical energy. Five or six months of confinement and hard 
mental work follow ; and, when he goes, he carries with him not. 
unfrequently pallid cheeks, a wasted body, and a spirit worn by 
anxieties and fatigue. How often have I been consulted for 
dyspeptic symptoms, headache, mental dejection or disquietude, 

25 



386 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

and various nervous disorder, for which I have been able to hold 
out the termination of the course of study as the only cure ! It 
is no dispraise to you, young gentlemen, to appeal to your pres- 
ent looks as confirmatory of what I have said. If your fair 
friends do not see in you all the bloom and rotundity which may 
please the mere physical eye, I will venture to pay them the 
compliment to believe, that they see and appreciate the deeper 
intellectual accomplishment, which has been gained at the ex- 
pense of the outer man. Let them look on you some twelve 
months hence ; and, unless my observation in similar cases has 
been strangely fallacious, they will discover no deficiency of 
health and manly vigour. But, with my opinion of the sex, I 
would infinitely prefer, to the mere admiration of external form, 
that feeling of inward approval, of respect for labours achieved 
and honours won by meritorious effort, which woman is so apt 
to evince, and which speaks so strongly of her own pure and 
noble nature. If, then, I may be permitted to turn for a moment 
from you to those who have honoured you and us with their 
presence this morning, I would beg of them to join us in the 
effort to give the character of the medical student that place in 
general estimation which it merits. They will thus not only be 
doing an act of justice, but will contribute to the still further ele- 
vation of that character, by offering to those who may hereafter 
come among us the strongest inducement to support and im- 
prove the reputation which their predecessors left them, and 
sedulously to avoid everything which might fix the least stain 
upon it. 

But let us return from this little digression into which the 
occasion tempted us, and set out upon a brief anticipatory 
journey through the future that lies before you. The dreamer 
crowds the events of years into a few minutes. Let us dream 
ourselves on the path of life together. Perhaps we may be able, 
by a rapid course, to reach the end of it before we part. Per- 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 387 

haps, too, some thoughts may spring up, some hints be gathered 
by the way, which may remain when the dream is over, and 
serve a useful purpose on the real journey which is to follow. 

Your first steps are those of exultation and gladness. You 
have aspired, have laboured, have denied yourselves, and have 
won. The goal is reached ; the prize is in your hands. And 
now for home, sweet home ! Ah ! the delight of returning once 
more to assured affection. The father's benignant greeting ; 
the deep tenderness of the mother's eye ; the mingled smile and 
tear of the sister; the boisterous glee of the young brother; and, 
it may be, the warm blushes of one not less loving or beloved ; 
what is there in life more delicious? All nature exhales sweets 
for you in this morning of your journey. Earth, air, and water ; 
the field and the stream ; man and his works ; and lovely woman, 
the crown and the charm of all, spread for you the feast of en- 
joyment everywhere upon your way. Soul and body expand 
under these genial influences. The sickly hue and languor of 
study give way to the bloom, the vigour, and activity of health. 

But this stage of excitement passes. Man was not made for 
self-indulgence. Your long labours have gained for you a brief 
period of exuberant gratification. It is the reward of toil. But 
nature has paid her dues, and in her turn puts forward the in- 
evitable claim, either labour or suffering. We have been gifted 
with powers mental and bodily. These powers were given to 
be used ; and the penalty for not using them is pain. The limb 
always at rest suffers with an aching void ; the body unexercised 
is punished with the tortures of dyspeptic and nervous disorder ; 
and mental inertness is almost surely attended with the horrors 
of ennui. But nature is not unkind; though she exacts labour 
under the penalty of suffering, she repays it with enjoyment. 
Every faculty has connected with it a chord, that incessantly 
vibrates pleasure when the faculty is duly exercised. Paradox- 
ical as it may seem to you, I believe that the purest and most 



383 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

lasting gratification in this world, is that which waits upon the 
full and even laborious exercise of each faculty to its legitimate 
end ; whether of the bodily powers to their ends, the intellectual 
to theirs, or the moral, including the conscience, to theirs. The 
commencement of laborious efforts may be distasteful ; there 
may be frequent occasions for painful self-denial ; and the firmest 
control of the passions may sometimes be necessary to restrain 
their irregular tendencies ; but a balance fairly struck will show 
a great preponderance in the scale of enjoyment. 

The point in your life-journey that we have now reached, is 
one at which you are called on for a decision, upon which must 
turn the happiness of your whole future. Too many, intoxicated 
by the brief draught of pleasure, and indisposed to relinquish it, 
attempt to supply the first vague uneasiness of satiety, and to 
quiet the troublesome calls of conscience, by the aid of artificial 
excitement, of the short joys of intemperance, the delirious ex- 
cesses of the passions, or the scarcely less noxious influence of 
mental dissipation. They fall off by the way. Some are lost, 
and heard of no more. Others linger out a miserable existence, 
with health destroyed by excess, and minds dead to enjoyment, 
useless to the communitv, and a burden to themselves. A few 
are arrested in their downward course of dissipation, vice, and 
wretchedness, and succeed in regaining the starting-point, after 
long and uncertain struggles, to begin anew the great work of 
life, with powers rusted by neglect, and feelings blunted by pre- 
mature indulgence. Oh! gentlemen, may no one of you incur 
this sad fate ! May yours, one and all, be the choice of prudence 
and wisdom ! 

Most happy is it for many of you, that you are not overloaded 
with this world's treasures ; that necessity will come in aid of 
your better resolutions, and urge you on in the right path. 
There are few misfortunes greater for a young professional man 
than to be independent of the world. The temptations to self- 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 389 

indulgence are almost too strong for those not aided by long 
habit to resist. I have greater respect for no man than for him, 
who, with all the pleasures of the world at his command when 
young, holds a firm rein over his propensities, and mounts the 
laborious ascent of honour by his own determined efforts. He 
richly merits whatever eminence he may gain. But, in the 
mean time, those of you who are not exposed to his temptations, 
instead of repining at your lot, should congratulate yourselves 
on your exemption, and on the greater probability it affords you 
of one day attaining all that an honourable ambition can hold 
out as desirable in this world. Be assured that, if you consult 
those who have preceded you, and reached the eminence at 
which you aim, the great majority of them will tell you, that 
one of their greatest causes of thankfulness is to have escaped 
the dangers of wealth, and even of competence, in early life. 

' Well, gentlemen, you are resolved to struggle manfully for 
professional success. But, you may ask, how are we to struggle 
when there is nothing for us to do ? Now, here again is a bless- 
ing in disguise. One of the worst results for you would be to 
rush at once into the full tide of business. Employed in prac- 
tical duties, you would have no time, and probably no disposition 
for self-improvement. You would be arrested at the point of 
progress at which you stand ; and, though a certain amount of 
income, and a certain professional position might be attained ; 
yet these would fall far short of the highest; and you might, as 
you advanced in life, have the mortification to see yourselves 
outstripped by those who had, in their early career, enjoyed and 
availed themselves of the opportunity of enlarging their store of 
professional and general knowledge. The first few years of a 
physician's life, during which he is awaiting the slow incomings 
of a regular business, are a precious opportunity, upon the proper 
use of which much of his subsequent prosperity must depend. In 
the schools, and the regular course of study, you have acquired 



390 AX ADDRESS TO THE MEDICAL GRADUATING CLASS. 

the elements of your profession. You have had a foundation 
laid, upon which you are yourselves to build. Instead, then, of 
folding your arms in listless idleness, or dissipating your time in 
irrelevant pursuits, or repining in moody inertness over the 
slowness of your success, bend your energies to the acquisition 
of knowledge and skill : study the records of the past ; by a close 
observation, make the experience of your older contemporaries 
your own ; seize every opportunity which the sufferings of the 
destitute may afford you of improving yourselves, while you 
extend aid to them ; even wander out occasionally into the 
regions of general literature, and garner up thoughts, facts, and 
feelings, which may tend to enrich and adorn your mental struc- 
ture, and give your whole character, both in itself and in the 
eyes of the world, the amplest development and fairest propor- 
tions. Depend upon it, your labour will not be thrown away. 
Opportunities occur to all men. They occur in vain only when 
there is a want of disposition or qualification to make use of 
them. Be prepared to meet the advances of fortune, and she 
will be r nre to befriend you. The great danger is of premature 
discouragement. Many a professional man has thrown himself 
away, when approaching success was almost within sight ; when 
it was about to turn the very corner, upon which his despairing 
eye had just taken its last look, before his departure into other 
scenes and strufrsrles. 

Let me tell you of another rock on which young men too often 
split. It is the rock of false pride. Xothing is more disgusting 
than an over-pushing disposition, resolved to gratify itself at any 
sacrifice of honourable feeling, independence of character, or 
regard for the rights of others. But distaste for such an exhi- 
bition does not justify that absurd pride, which shuts itself up 
in its own shell, and expects the world to approach, and beg 
that it would come forth, and warm itself in the sunshine of its 
favour. The world has a right to expect that we should make 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 391 

known our ability to serve it : and he who neglects all honour- 
able opportunities of favourably impressing the community in 
which he lives, has no right to expect its aid in the furtherance 
of his own purposes. 

I repeat that, with qualifications improved by culture, with all 
due personal efforts, and with a proper perseverance, you can 
scarcely fail of success in the end. It may be that all of you 
have not resources upon which you can rely until success may 
come. But there are honourable means by which an energetic 
young man may supply the deficiencies of professional income ; 
and rigid personal economy, with a prudent avoidance of prema- 
ture responsibilities, will always enable him, if in health, to 
supply his essential wants, if not exactly on 'the spot which he 
might prefer, yet in some part or another of this vast country. 
Determine only that you will not live on the future, that you 
will not allow yourselves to enjoy pleasures that you have not 
earned, that you will not fall into the fatal error of supposing 
yourselves entitled to begin life, with all the comforts and indul- 
gences which your parents may have won for themselves before 
its close ; determine thus, and I can almost guarantee you 
against ultimate failure. 

But should your expectations be disappointed, should it seem 
evident to you, after due patience, whether with or without fault 
of your own, that satisfactory success in your profession is unat- 
tainable ; do not, I beg of you, in your despair, descend into 
any degrading practices. Leave the whole ground of quackery 
free to ignorance and imposture, without competition from you. 
Some regularly educated physicians, I say it with shame and 
sorrow, have deserted the banner under which they had enlisted, 
and thrown themselves recklessly into the empirical ranks. 
They may, in some instances, have received the pecuniary 
recompense they sought for ; but I need not tell you of the con- 
sciousness of merited contempt, and of the self-loathing which 



392 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

fester under the gilded exterior of their fortunes. Ignorance 
may plume itself upon success in the stratagems and impositions 
of quackery; but intelligence never can sink to that miserable 
level, without an inward contempt and scorn of the baseness, 
which, brazen-faced as it may be before the world, will forever 
cling to the innermost conscience with a vulture-like tenacity. 
Anything but this, gentlemen ! If you cannot succeed regularly 
in your profession, leave it ; seek your fortunes in some other 
honourable or honest calling; become lawyers, merchants, 
manufacturers, farmers, mechanics, labourers ; if necessary, 
stitch, or cobble, or dig for a living ; nay, starve, if it must be 
so ; but never turn to quackery. There is, however, no danger. 
You cannot be guilty of the baseness. I do not know whether 
an apology is not due to you for the mere hypothetical suppo- 
sition. 

We will take it for granted that you have succeeded in your 
profession. You have merited and gained the confidence of 
your neighbours. Hundreds look to you as the guardians of 
their health, their main earthly hope in the agonies and dangers 
of disease. Here is an immense responsibility. The sacred ark 
of human life has been intrusted to your keeping. You are an 
anointed priesthood in its service. How important that your 
hands should be clean, your hearts pure, and your souls deeply 
reverent in your ministrations ! This, gentlemen, is the light in 
which you should habitually view your profession ; not as a mere 
business ; not as a mere avenue to competence or wealth ; but as 
a covenant with the Most High, by which you are devoted, soul 
and body, to the good of your fellow-men, so far as that may 
depend on life and health. The ox, however, must not be muz- 
zled that treadeth out the corn. You have a r-ight to expect 
from your labours a support equal to the dignity of your calling. 
But this should be looked on as incidental; as an' important, or 
even essential accessory, if you please ; but not as the great end 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 393 

and aim. He who enters the medical profession with a merce- 
nary spirit, will almost necessarily come short of its highest 
requirements. Aiming at the appearance rather than the reality 
of skill, he will think more of the impression he may make on 
others, than of a proper understanding and treatment of the 
disease. Where nothing is to be gained but the consciousness 
of duty fulfilled, he will be little apt to spend time and labour, 
which might yield him more if applied elsewhere, or at least 
would be abstracted from his pleasures. For the frequent self- 
denial, the steady devotion Of thought and energy, the unwaver- 
ing guard over his precious charge, as well when unseen as 
when seen of men, which characterize the right spirited prac- 
titioner, he has no sufficient inducement. He will be almost 
necessarily more or less superficial. He never can be the true 
model physician. Just in proportion as medicine is cultivated 
in the mercenary, or in the pure professional spirit, will be its 
decay or advancement in efficiency, real dignity, and acceptance 
with God and man. 

Be this, then, a-entlemen, vour great care — to establish and 
cultivate proper notions of your high calling ; to fix in your in- 
nermost convictions the truth that you are engaged in a great 
mission, and responsible to Him who sends you forth for its due 
discharge. This feeling will be the best preservative against 
every temptation ; against the solicitations of indolence or pleas- 
ure ; the hateful suggestions of envy; the unkindly influence of 
opposing interests ; and the irregularities of all sorts that spring 
up, like noisome weeds, in the rotten soil of an avaricious or 
grasping spirit. 

Time is not left to sketch that round of duties, of things to be 
done and avoided, of feelings to be cherished or subdued, of rela- 
tions to be preserved with the public, the sick, and your medical 
brethren, which constitute the ethics of your profession. But 
they all fall within the great general principle already referred 



394 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

to. Get the true professional spirit, and all else that is needful 
or desirable will be added unto it. Nevertheless, you will find 
great aid from the study of those written rules, which the wise 
and good among your predecessors have deduced from an ample 
experience, cultivated judgment, and enlightened conscience. 
Such a code of ethics has been adopted by the great national 
medical association, and published as a guide to the whole pro- 
fession. I would urge on you to study it thoroughly, and make 
its rules the laws of your professional life. Based, as they are, 
upon sound morals and a lofty feeling of honour, they cannot 
but lead, if duly observed, to the elevation of our calling in use- 
fulness, dignity, and respect, and consequently to the personal 
advantage of every conforming member. 

Before coming to the closing scene, let us picture to ourselves 
your position, when, in the middle or decline of life, having 
struggled manfully through early difficulties, you are firmly fixed 
in the confidence of the community, with a consciousness that 
you have lived up to the capacities with which Heaven has 
endowed you, and endeavoured, so far as is compatible with 
human infirmity, to make your conduct conform with your con- 
victions of social and professional duty. Let us see whether 
there is not something in such a position worthy of the aspira- 
tions of the young, and calculated to encourage them in a course 
of honourable effort, and virtuous self-denial. 

You are in the midst of those who feel themselves indebted to 
you, either in their own person, or that of their nearest friends, 
for the continuance of life and health, or associate you affection- 
ately with the memory of lost relatives, whose sufferings have 
been alleviated, and their last moments cheered by your kind 
and indefatigable attentions. If a soured temper, or perverted 
heart, may occasionally seek satisfaction in misinterpreting or 
misrepresenting your best exertions, it is only an evil which is 
incident to humanity in every station ; a slight mixture of bit- 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 395 

terness in your cup, which, though not agreeable to the taste, 
may have an invigorating influence on the mental health. No 
profession probably offers less occasion for unkindly feelings. 
You thwart no interests in your progress; your success is not 
attained at the expense of others ; yours is not the reckless 
course which crushes under its iron wheels whatever of respect, 
competence, hope, enjoyment, or any other pleasant or valuable 
thing, may lie in its ambitious way. Your aim is always the 
good of others; your triumph is also theirs. Wherever you go, 
you scatter hope, or joy, or consolation. Not only affection, but 
respect and esteem attend you. Social influence, and the power 
to do good in other w T alks than the purely professional, are 
yours. The comforts of life, and not unfreq*uently even its ele- 
gancies and superfluities, are at your command. If without 
political power and station, it is only because these are incom- 
patible with your pursuits, habits, and tastes. The highest in 
the world deem themselves not dishonoured by your association 
and friendship. Your name and character are a rich inheritance 
for your descendants for generation after generation. Is not this 
a position fully worth all its cost ? Is it not a sufficient com- 
pensation for the early labours, the trials, the patient waiting, 
the watchings, fatigues, anxieties, for all, indeed, but the awful 
responsibilities of a physician's life ? For the burden of these 
responsibilities, an approving conscience, and the trembling 
hope that the most merciful may overlook the shortcomings of 
human weakness, are the only adequate recompense. 

And now, gentlemen, we have come to the last scene of life, 
This is usually looked on as an occasion from which the thoughts 
are to be turned away as from some fearful object, the contem- 
plation of which is calculated to throw a shade of gloom over 
every present and coming enjoyment. But this is a great mis- 
take. Death is inevitable ; and it is cowardice not to be willing: 
to look it steadily in the face. In the physician especially, whose 



396 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

path it constantly crosses, who cannot hope to exclude its pres- 
ence, it is extreme weakness to shut the eye against it, and thus 
endeavour for a brief space to dream of an impossible exemption. 
We should accustom ourselves to regard it firmly, to strip it of 
imaginary terrors, to see in it whatever there may be of good or 
of evil, and calmly to prepare ourselves accordingly. This is 
the part not only of religion, but of philosophy. An habitual 
feeling of the uncertainty of life, in the properly constituted 
mind, is one of the best safeguards against all irregularities of 
thought or deed, and the surest guide back to the right path after 
any temporary wandering. Let us then cherish this feeling. 
We shall find it incompatible with no innocent pleasure ; we 
shall even find it a consolation in trouble; and should misfor- 
tunes overwhelm us, we shall see in it at least one star beaming 
through the tempest, and betokening a clear sky beyond. To 
the duly prepared mind, death, come when it may, whether in 
the morning, the noon, or the evening of life, is no evil. If in the 
midst of joys, it saves us from the sorrows that surely follow; 
if in trouble, it gives relief; if in a course of honourable useful- 
ness, it embalms our memory sweetly in the common mind ; if 
at the close of a long and upright career, it comes as a kind 
friend, to free the spirit from the burden of flesh, which can no 
longer serve it as an instrument of action or enjoyment. May 
yours, my young friends, and may ours be the lot, when this 
messenger shall call, to be prepared to follow, with the calmness 
of a peaceful conscience, and the well-grounded hope of a happy 
futurity ! 

But, gentlemen, you may recollect that we have been occupied 
bv a dream of life. We are now awake again, and back in the 
present. This is probably the last occasion upon which we shall 
all be in one place together. To-morrow; and you will be scat- 
tered towards every corner of our common country. Allow me 
to express the sincere hope that you will carry with you kindly 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 39T 

recollections of your teachers, and your alma mater ; and that, 
in the varied experience that awaits you, your thoughts will now 
and then wander pleasingly back to these scenes of your young 
labours and success. Be assured that, wherever you may go, 
and whatever maybe your lot, } r ou will have with you our warm 
sympathies, and our zealous wishes for your welfare, present 
and eternal. 



BIOGRAPHICAL MEMOIRS 



A MEMOIR 



OF 



THE LIFE A XT) CHARACTER 



OF THE LATE 



JOSEPH PARRISH, M.D., 



READ BEFORE 



THE MEDICAL SOCIETY OF PHILADELPHIA, 

OCTOBER 23d, 1840. 



The office assigned me by the Medical Society of portraying 
the life and character of the late Dr. Joseph Parrish, is a 
trust most grateful to my feelings. To be appointed to speak 
of such a man before such an audience, is a mark of respect 
which no one could fail to value ; but a still higher source of 
gratification, in the present instance, is the opportunity afforded 
me of giving utterance to those sentiments of esteem and warm 
affection which I ever cherished for the deceased, and which I 
still cherish for his memory. 

I do not propose to enter into much minuteness of biograph- 
ical detail. This is forbidden by the necessary brevity of an 
address like the present, and by the nature of the occasion, 
which calls less for a narrative of the ordinary incidents of life 
than for the just representation of a medical character, pleasing 
by its beautiful traits, and useful as a rare pattern of what is 

26 (401) 



402 A MEMOIR OF DR. JOSEPH PARRISH. 

most praiseworthy in our profession. The man, however, was 
in Dr. Parrish so intimately blended with the physician, his pro- 
fessional excellencies flowed so directly from the qualities of his 
heart and intellect, that no portrait of his medical character 
would be recognized, which should not also present the striking- 
lineaments of his moral nature. In the following sketch, there- 
fore, having offered some notices of his parentage, education, 
and general course of life, and especially such as may illustrate 
his character, or may appear to have had any influence in its 
formation, I shall endeavour to revive in vour recollection his 
distinguishing moral and intellectual peculiarities, and then 
to trace those qualities as a physician and medical teacher which 
rendered him so extensively useful, and so highly esteemed in" 
this community. 

Dr. Parrish was descended from one of the early settlers of 
this country. His great-grandfather, John Parrish, who was a 
native of England, though of Dutch extraction, commanded a 
merchant vessel trading to the Chesapeake, and afterwards be- 
came surveyor-general of Maryland, where he took up consider- 
able tracts of land, on a portion of which some of his descend- 
ants still reside. He perished in a storm by which he was 
suddenly overtaken while in a small boat on the Chesapeake, 
returning from a visit to a ship sailing up the Bay. The 
grandfather of the Doctor, also named John Parrish, died in 
possession of a landed estate, on which a part of the city of 
Baltimore now stands. This, however, was lost to his family, 
though the title to it is said never to have been surrendered ; 
and application was made, at a comparatively recent period, to 
the subject of the present memoir, to join in an effort for its re- 
covery, with the assurance that there were good grounds to hope 
for a successful result. The determination of Dr. Parrish, on 
this occasion, was strikingly characteristic. He promptly declined 
the proposition, on the ground that no advantage which could 



A MEMOIR OF DR. JOSEPH PARRISH. 403 

accrue to himself or his family would counterbalance the uncer- 
tainty, inconvenience, and positive distress into which numerous 
individuals might be thrown by the agitation of the subject, who 
had honestly acquired their titles, and were now relying on them 
with undoubting confidence. 

Isaac Parrish, the father of the Doctor, was one of a con- 
siderable family, who, upon the death of their mother, were 
left almost destitute, and were sent to Philadelphia, in compli- 
ance with her request, to be placed under the care of some near 
relatives of hers residing in this city. He had been intended 
by his parents for a physician ; but the means for carrying their 
intention into effect were found to be wanting after their death ; 
and he was placed as an apprentice with . a very respectable 
hatter, whose daughter he afterwards married. Honest, frugal, 
and industrious, he succeeded well in his business, supporting 
and educating a numerous family, and retiring, in the decline of 
life, upon a decent competence, with the respect of all who 
knew him. He was especially esteemed in the Society of 
Friends, of which he was a consistent member, and in which 
both he and his wife held highly respectable stations. The re- 
ward of a virtuous life has seldom been more happily exempli- 
fied than in the old age of this venerable couple. They lived 
sixty-six years together in unbroken harmony, and died within 
a short period of each other at a very advanced age. Their 
last years were cheered by the affectionate attentions of their 
few remaining children. They who enjoyed the familiar inti- 
macy of Dr. Parrish cannot but vividly remember his beautiful 
deportment towards his aged parents. The youngest of eleven 
children, of whom the greater part died early, he was their joy 
and consolation throughout life ; in youth obedient, in manhood 
affectionate and attentive, and, when the weakness of old age 
came upon them, all that was tender and respectful ; so that, 
when he finally closed the eyes of his venerable father, he could 



404 A MEMOIR OF DR. JOSEPH PARRISH. 

say with sincerity that he was not conscious of having ever 
offended him. 

Dr. Parrish was born on the 2d of September, IT 79. He re- 
ceived a good English education, and was taught Latin at the 
Friends' school in Fourth Street, at that time in considerable 
repute as a place of instruction in the learned languages. He 
afterwards paid some attention to French, and still later in life 
to the Hebrew, which he cultivated exclusively in reference to 
the study of the Bible. He could not, however, be said to have 
a decided literary turn; and, though he took care to qua!:: y 
himself well as a physician by a somewhat extensive course of 
medical reading, and in the few leisure intervals of a very active 
life, occasionally perused works of general interest, yet he was 
indebted, as well for his professional skill as for his extensive 
knowledge of men and things, less to books than to an extra- 
ordinary faculty of observation, and a memory unusually 
tenacious of facts. He nevertheless always attached great im- 
portance to mental culture ; and, in his last will, while giving 
directions in relation to the education of his children, he ex- 
presses the sentiment, that he would rather a child of his should 
expend every cent of his inheritance in the acquisition of knowl- 
edge, than that he should arrive at maturity, in possession of a 
large estate, without the advantages of scientific attainment. 

The moral and religious education of Dr. Parrish was of the 
most guarded kind. He was brought up in strict conform 
with the principles and habits of the Society of Friends, and 
early in life received strong religious impressions, which pre- 
served him in a remarkable degree from the temptations of a 
warm and lively temperament. From some notes which he left 
behind him, made about the commencement of his medical 
studies, it appears that, even in youth, he was under the habit- 
ual guidance of that inward principle, in which the Friends 
recognize the Divine Spirit operating upon the mind, and the 



A MEMOIR OF DR. JOSEPH PARRISH. 405 

reality of which is one of the prominent points of their religious 
faith. Upon this subject I shall have occasion to speak more 
fully hereafter ; as there was scarcely an important act or event 
of the life of Dr. Parrish, which did not receive impulse or 
modification from his settled convictions in relation to this mon- 
itor within him ; and to leave it out of view would be to present 
an imperfect, if not an inaccurate picture of his character. 

But, while thus moral according to the strictest rules of his 
self-denying sect, he indulged freely in the innocent sports and 
recreations of boyhood, and was distinguished among his com- 
panions by his skill in various athletic exercises. He was a 
swift runner, a good swimmer, and an excellent skater. In the 
facility, grace, and rapidity of his movements upon the frozen 
surface of the Delaware, few if any of his contemporaries sur- 
passed him. This accomplishment he carried with him into man- 
hood ; and it is related of him when in middle age, and in full 
reputation as a physician, that, having occasion to make a pro- 
fessional visit, during winter, upon the opposite bank of the 
river, he accepted from a friend the loan of a pair of skates, and 
astonished the spectators by some of those complicated and 
graceful evolutions which have now become almost an affair of 
tradition among us. His aversion to confinement and fondness 
for the free and fresh air never forsook him. Throughout the 
whole course of his life, he could nqt tolerate a close and heated 
apartment, slept always in summer with his windows up, and 
even during illness found a degree of coolness essential to his 
comfort, which was almost hazardous to his attendants. There 
is no doubt that this personal predilection influenced greatly his 
course of practice ; and, long before the profession generally, in 
this place, were prepared to adopt the plan, he had introduced 
into the treatment of various diseases a system of exercise, ex- 
posure to cool air, and free indulgence in cool and refreshing 
drinks, which, to the great comfort of the patient and success of 



406 A MEMOIR OF DR. JOSEPH PARRISH. 

the physician, have at length, in many instances, superseded the 
old system of drugs, warm beverages, and confinement. 
• His youthful partialities were strongly directed towards the 
study of medicine ; and those among his early friends who after- 
wards witnessed his extraordinary professional success, took 
pleasure in recalling many evidences which he had exhibited, 
even in boyhood, of a natural turn and natural qualifications for 
this pursuit. He was fond of reading upon the subject of dis- 
eases, exhibited an instinctive disposition to visit and nurse the 
sick, and, in the absence of other modes of indulging his pro- 
pensity towards the healing art, is said to have exercised his 
skill upon the inferior animals, and to have exhibited some dex- 
terity in the treatment of their fractured limbs. The fears of his 
parents, howerer, were for some time an obstacle to the gratifi- 
cation of his wishes in the choice of a profession. They were 
unwilling to expose the strictness of his religious principles, the 
purity of his morals, and the simplicity of his habits and feelings 
unnecessarily to the seductions of the world : and entertained a 
belief, much more common at that time than at present among 
the Friends, that a strict observance of their peculiar views and 
customs as a sect, was incompatible with the various tempta- 
tions to which the student of medicine was subjected. Respect- 
ing, though not acquiescing in these parental fears, he surrendered 
his own wishes, and entered into the shop of his father with the 
view of qualifying himself for conducting the business of a hatter, 
rather, however, in a mercantile than a mechanical capacity. In 
the most brilliant period of his subsequent career, he never had 
the weakness to look back with regret upon the occupation of 
his earlv life, or the remotest wish to conceal it from others. On 
the contrary, he always entertained great respect for mechanical 
pursuits, and considered a descent from honest and worthy 
parents, however humble their station, as a juster ground of 
self-congratulation than the highest splendour of ancestry with- 
out the accompaniment of virtue. 



A MEMOIR OF DR. JOSEPH PARRISH. 407 

In this position he continued till his twenty-second year, when, 
as his own inclinations remained unaltered, and the objections 
of his parents had yielded to more mature reflection, and per- 
haps also to increased confidence in his stability, he felt himself 
at liberty to engage in the study of medicine, and accordingly 
entered as a private pupil into the office of Dr. Wistar, at that 
time Adjunct Professor of Anatomy and Surgery in the Uni- 
versity of Pennsylvania. The advice and example of the late 
Dr. Samuel Powell Griffitts, who was in great esteem as a phy- 
sician, and was at the same time a strict and conscientious 
Quaker, had considerable influence in bringing about this result. 
For this and numerous other friendly offices of that gentleman 
in promoting his professional interests, Dr. Parrish always en- 
tertained the most grateful feelings ; and a friendship sprang up 
between them, which was fruitful in mutual service, and con- 
tinued without abatement till the death of Dr. Griffitts. 

The mode of conducting medical education was in those times 
very different from that which now prevails in this city. Physi- 
cians supplied medicine as well as advice ; and it was among 
the duties of the student to put up the prescriptions of his pre- 
ceptor as they were brought to his office, and even to carry out 
the preparations himself in cases of peculiar urgency. I have 
often heard Dr. Parrish speak of the errands on which he was 
dispatched, by day and by night, over all parts of the town, con- 
veying the messages of his preceptor, and distributing medicines 
among his patients. The student also not unfrequently visited 
the sick, nursing them, sitting up with them at night, and occasion- 
ally affording his advice upon emergencies when immediate access 
could not be had to the principal. In relation to his reading, he 
usually received some general directions from his preceptor, to 
whose library he had access ; but was seldom subjected to a 
routine of study and close examinations such as are now com- 
mon, and was therefore more or less deficient in that precision 



408 A MEMOIR OF DR. JOSEPH PARRISH. 

of elementary knowledge which characterizes the student of the 
present day. I am fully convinced that the plan of education 
which now prevails is the most efficient ; as it insures a good 
foundation, upon which experience may subsequently build, and 
which, if wanting in the outset, is seldom afterwards obtained. 
But there were some advantages in the old mode, and among 
these were greater originality and independence of thinking, 
greater practical facility arising from frequent intercourse with 
disease, and a more thorough acquaintance with medicines and 
the modes of preparing them. The peculiarities of his education 
were to be traced in the subsequent course of Dr. Parrish ; and 
to this origin we may ascribe the strong bent of his mind towards 
practical observation and experience, in preference to abstract 
reasoning and theoretical disquisition in medicine. He certainly 
availed himself fully of all his advantages, and by his industry 
and close attention, as well as by a congenial goodness of heart 
and obligingness of disposition, succeeded in gaining the esteem 
and entire confidence of his preceptor, who loved him as a 
younger brother, and treated him throughout life with a kind- 
ness which gained in return his whole affections. Those of you 
who have listened to the medical lectures of Dr. Parrish, cannot 
but recollect how frequently and respectfully he quoted the senti- 
ments of his old master, as he was wont to call him, and how 
unreservedly, on all occasions, he expressed his admiration of 
the character, and his grateful sense of the favours of that good 
and great physician. 

He received his degree of Doctor of Medicine in the University 
of Pennsylvania in June, 1805, having written an inaugural essay 
" Upon the influence of the passions in the production and cure 
of diseases," which was printed, in compliance with a rule of the 
University existing at the time. This essay exhibits the practical 
turn of his mind even at that early period, consisting chiefly of a 
collection of facts, gathered from various sources with no little 



A MEMOIR OF DR. JOSEPH PARRISH. 409 

industry. After his graduation, he spent a short time in the 
recreation of travel, and upon his return, about the close of sum- 
mer or beginning of autumn, entered upon the duties of his pro- 
fession, as resident physician in the Yellow Fever Hospital. It 
was under a most solemn sense of his responsibility that he thus 
commenced his professional career. He felt habitually that he 
was in the immediate presence of his Maker ; and from his 
private notes it appears that, conscious of his own weakness, he 
constantly sought for aid from that gracious power, whose will 
he endeavoured to make the rule of his life, and before whose 
judgment-seat, in his own breast, he strove to bring up every 
proposed act for approval or rejection. With such feelings, it is 
superfluous to say that he distinguished himself in the hospital 
by a devoted attention to the duties of his station ; and his native 
benevolence co-operated with his sense of right, in leading him 
to apply every alleviation in his power to the miseries by which 
he was surrounded. 

The favourable impression, made by his services in this situa- 
tion, was afterwards increased by the publication of some ex- 
periments in relation to the poplar worm, which were of great 
effect in allaying a very singular panic, at that time prevalent 
throughout the country. An individual was found dead in his 
bed, and a living worm along with him, of that kind which fre- 
quents the Lombardy poplar, and is thence commonly called 
poplar worm. The public somewhat unphilosophically leaped 
to the conclusion that the worm and the sudden death were in 
the relation of cause and effect. Rumour speedily collected 
numerous confirmatory observations ; in the hot-bed of popular 
fear suspicions quickly ripened into facts ; and the belief came 
to be very widely diffused that this species of worm was ex- 
ceedingly venomous, and that a frightful death was lurking in 
every Lombardy poplar in the country. A w T ar of extermination 
commenced both against the worm and the tree which sheltered 



410 A MEMOIR OF DR. JOSEPH PARRISH. 

it. The one was slaughtered without mercy, the other given 
everywhere to the axe and the flames : and our streets would 
soon have been left without shade, but for the timely publica- 
tion of the experiments alluded to, which conclusively proved 
that the worms were harmless, and the Lombardy poplar as 
guiltless of any noxious influence as it was of any extraordinary 
beauty. 

But the event which, in the early career of our late friend, 
contributed most to make him favourably known to the public, 
was the delivery of a course of popular lectures on chemistry, 
which he first gave in the winter of 1807-8, and repeated twice 
afterwards in successive years. Popular lectures on scientific 
subjects were then a novelty in Philadelphia. Their annuncia- 
tion was much more calculated to attract attention, and a suc- 
cessful essay was much more striking and permanently influential 
than they would be at the present day, when the public has be- 
come accustomed to such claims upon its attention, and one 
impression is so rapidly followed by another, that a lasting 
effect is seldom produced. Dr. Parrish knew how to mingle the 
agreeable most happily with the useful, and his aim was always 
as much as possible to unite the two. To be merely amusing 
was contrary both to his principles and his taste ; but no one 
was better aware of the necessity of throwing about dry details 
the embellishments of happy illustration and a pleasing delivery; 
and, however strict in his religious opinions, he would have as 
little thought of denying to his subject whatever interest of this 
kind he could impart to it, as of stripping a vernal landscape of 
its leaves and flowers, or a summer shower of its rainbow. He 
endeavoured to give to his instructions a practical bearing upon 
the ordinary pursuits of life, mingled with the chemical details 
various physiological observations calculated to obviate the too 
natural tendency of the uninstructed to empiricism, and took 
advantage of the numerous opportunities, offered by his subject, 



A MEMOIR OF DR. JOSEPH PARRISH. 411 

to illustrate the wisdom and goodness of Providence, and to 
mingle lessons of piety with those of science. There is no doubt 
that he contributed by these lectures to awaken that spirit of 
popular instruction which has uot since slumbered in our city; 
while he earned for himself a reputation, highly advantageous 
in the prosecution of his professional views. 

In the mean time he had been attending diligently to practice, 
and was acquiring, in the arduous labours of the Philadelphia 
Dispensary, that experience of disease which was necessary to 
confidence in himself, and to inspire confidence into those who 
might from other causes be disposed to favour him. He was 
chosen one of the physicians of the institution in 1806, and con- 
tinued to serve it zealously until the increase o'f his private busi- 
ness compelled him to withdraw. Upon his resignation in 1812, 
he received the thanks of the managers " for the faithful dis- 
charge of the duties of his office for six years and a half." In 
1818, he was himself elected a manager, and in 1835 was ap- 
pointed one of the consulting physicians of the institution ; and 
the latter station was retained by him to the time of his death. 

In October, 1808, about three years after he had commenced 
practice, having been so far successful as to feel justified in in- 
curring the additional expenses of a family, he married a young 
lady from Burlington, the daughter of John Cox, one of the 
most respectable citizens of New Jersey, and then as at present 
a highly esteemed preacher in the Society of Friends. This 
connection was in every way happy for Dr. Parrish. It threw 
an almost uninterrupted sunshine over the course of his domestic 
life, and surrounded him at its close with the consoling sympa- 
thies of a large and most affectionate family, whose love and 
reverence he had earned by a cordial participation in their feel- 
ings, and an ever-active yet well-regulated interest in their wel- 
fare. His wife survived him, and he never had to mourn the 
loss of a child. Few men have been more exempt from the 



412 A MEMOIR OF DR. JOSEPH PARRISH. 

miseries which but too frequently invade the domestic circle,, 
and few have better deserved such exemption. 

There has, perhaps, been no example in Philadelphia of more 
rapid professional success than that which fell to the lot of Dr. 
Parrish. Various causes contributed to this result. Among 
them may be mentioned his fellowship with the Society of 
Friends, always favourably disposed towards their own mem- 
bers, and at that time capable of extending an effective patronage, 
as there were few physicians among them ; and the countenance 
of Dr. Wistar, who, on frequent occasions, exhibited confidence 
in the skill of his former pupil, and took every opportunity of 
promoting his professional interests. But it was undoubtedly 
to his own qualifications and efforts that he was chiefly indebted. 
I shall have occasion, in the subsequent part of this memoir, to 
speak of those peculiarities of manner and of character by which 
he was so favourably distinguished, and which were so happily 
in harmony with his pursuit. They were powerfully instru- 
mental to his success by inclining opinion favourably towards 
him, and thus giving full scope to the influence of his profes- 
sional excellencies, which might have escaped attention if 
wrapped in the garb of a repulsive manner, or have been neu- 
tralized in their effect if mingled with vicious propensities or 
opinions. 

I have before noticed certain events in his life which had the 
effect of bringing him advantageously before the public. He had 
already acquired a large practice, and was growing rapidly in 
reputation, when, in the winter of 1812-13, the great typhous 
epidemic, which so long scourged this country, made its appear- 
ance in Philadelphia, and elevated him at once into the foremost 
rank of his profession. At its first appearance, this complaint 
was not fully understood. Physicians were not generally pre- 
pared to recognize a disease of debility, associated with appa- 
rently violent inflammation, and were in the beginning too apt 



A MEMOIR OF DR. JOSEPH PARR1SH. 413 

to overlook the tendency to prostration, which lurked fatally 
beneath the show of excitement. The attention of Dr. Parrish 
had been strongly directed to the subject by the perusal of a 
treatise by Dr. North, who had seen much of the disease in New 
England, and who strenuously advocated the stimulant treat- 
ment. His aversion to theory in medicine left him open to the 
evidence of facts, however opposed to prevailing opinions ; and 
he was quite prepared to encounter the disease by methods 
which had stood the test of experience, rather than by those 
which analogy alone would appear to indicate. The epidemic 
approached Philadelphia through New Jersey, and hung for 
awhile over the opposite shore of the Delaware, before it burst 
upon our city. The inhabitants were alarmed by reports of a 
terrible disease in the town of Camden, which appeared to bid 
defiance to medicine. Dr. Parrish was called in to the aid of the 
physicians of the neighbourhood. At the period of his first visit, 
seven cases had occurred and all proved fatal. He was told that 
the disease was of an inflammatory nature, and had been treated 
by the lancet and other depletory measures. Its malignant 
aspect at once struck his attention. He saw through the veil of 
inflammation which it had thrown over its ghastly features, and 
beheld the deadly weakness beneath it. He advised an imme- 
diate abandonment of the lancet, and the substitution of an 
actively stimulant treatment. The effects were most happy. 
Numbers now got well where before all had died. A disease 
supposed to be almost incurable was found to be, in the great 
majority of cases, under the control of medicine. The terrors of 
the first awful reports gave way before the happier intelligence 
which followed ; and the newly inspired confidence was directed 
especially towards the author of the change. When the epidemic 
reached the city, Dr. Parrish found himself in the midst of an 
ample business ; and the devotion which he paid to the sick, and 
the skill and success which marked his efforts, gave him a place 



414 A MEMOIR OF DR. JOSEPH PARRISH. 

in the opinions and affections of his fellow-citizens which he did 
not lose when the immediate occasion ceased. His views of the 
disease and its treatment met with much opposition ; and some 
decision of character was required to carry them into effect. On 
one occasion, a physician in attendance with him upon two cases 
of the disease in the same family, believing them to be highly 
inflammatory, strongly urged the employment of the lancet, and, 
upon being resisted by Dr. Parrish, who felt convinced that the 
proposed remedy would be fatal, retired from attendance, leaving 
the whole responsibility with his colleague. The ground of dif- 
ference was known, and the eyes of the whole neighbourhood 
were directed with intense expectation towards the result. " You 
cannot conceive," said Dr. Parrish in relating the circumstance 
to his pupils, "the anxiety I experienced." Happily, however, 
both patients recovered, and the event contributed to extend his 
reputation. 

But his attention was not restricted to the practice of medi- 
cine exclusively. From the commencement of his professional 
life he had exhibited an inclination toward surgery, which he 
cultivated assiduously whenever opportunities were offered. 
Towards the close of the year 1806, he was elected surgeon to the 
Philadelphia Almshouse, where he had an ample field for ob- 
servation and experience, especially in that branch of the surgi- 
cal art, always highest in his esteem, which aims at repairing 
injuries by a judicious employment of the resources of the sys- 
tem, and, so far from seeking occasion for painful or deforming 
operations, endeavours to render them unnecessary. His repu- 
tation as a surgeon was of slower growth, but scarcely less dis- 
tinguished in the end than that which belonged to him as a 
medical practitioner. His skill in diagnosis and judgment in 
the choice of therapeutic measures were highly appreciated by 
his medical brethren, by whom he was constantly called into 
consultation, not only in Philadelphia, but also in the country 



A MEMOIR OF DR. JOSEPH PARRISH. 415 

for many miles around it. As an operator also he took rank 
with the most prominent surgeons of the city, and, at the period 
of life when his physical powers were at their height, was second 
only to Dr. Physick, either in the number and magnitude of the 
operations which he performed, or in the extent of his reputation 

In addition to his station in the Almshouse Infirmary, he- 
was in the year 1816 elected surgeon to the Pennsylvania Hos- 
pital as successor to Dr. Physick, and continued to discharge 
the duties of the two offices conjointly for about six years. His 
place in the Pennsylvania Hospital he retained till 1829, when 
the state of his health, which was at that time feeble, and a dis- 
position to relinquish the more fatiguing and severer offices of 
surgery to younger hands, induced him to withdraw entirely 
from professional connection with the public institutions. He 
considered the decline of bodily strength in a surgeon as an 
intimation from nature that the period for active service was 
passed ; and I have often heard him say, that the necessity of 
using spectacles was regarded by him as a call of duty to shun 
operations, in which a jet of blood from a divided artery might 
occasion temporary blindness. 

During the whole course of his service in the public hospitals, 
he "was assiduous in the discharge of his duties, not considering 
the situation as one of mere personal advantage, but as involving 
higher obligations, and among these a watchful care over the 
interests of the institution, and a strict attention to the comforts 
as well as the health of the inmates. I have never heard the 
breath of accusation against him in relation to the discharge of 
this high trust. It was in the Almshouse Infirmary that he 
first attracted notice by his clinical lectures, and laid the founda- 
tion of that reputation, as a medical teacher, with which all who 
now hear me are familiar. In his regular rounds among the 
patients, both in this institution and the Pennsylvania Hospital, 
he seldom omitted an opportunity of giving useful practical 



416 A MEMOIR OF DR. JOSEPH PARRISH. 

lessons to the students who attended him ; and, so attractive 
was his manner, so impressive his instructions, and so obvious 
the high motives by which he was actuated, that large numbers 
constantly followed him, who afterwards carried home with them, 
into almost all parts of the Union, a great and affectionate respect 
for his virtues, talents, and attainments. 

A natural consequence of his growing reputation as a prac- 
titioner and clinical lecturer was a great increase of private 
pupils. He was seldom without one or more students, even 
from the commencement of his practice ; but it was not till the 
year 1814, or 1815, that their number became considerable. 
From this period they rapidly increased, till they amounted at 
length to about thirty; a number at that time quite unprece- 
dented, in this country, among physicians not immediately con- 
nected with the great medical schools, and equalled, I believe, 
only in one instance where this advantage was possessed by the 
teacher. Young men came to study with him from various parts 
of the Union; but the greater number were of Philadelphia and 
its immediate neighbourhood ; and, as this was the place where 
he was best known, and no extraneous motives influenced the 
choice of the pupils, the fact speaks strongly in favour not only 
of his reputation, but also of his real merits. Among the present 
practitioners of this city, there are, I presume, more of his former 
pupils, than of those educated by any other physician. He was 
in the habit of lecturing to the young gentlemen in his office 
twice a week, during almost the whole year ; in the winter upon 
surgery, and in the summer on the practice of medicine; giving 
in his lectures not so much that elementary knowledge which is 
to be derived from books, as the result of his own experience 
and reflection. 

About the year 181 8, he was induced by the great increase of 
his pupils, and by his own almost oppressive engagements, to 
procure assistance in the instruction of his class, especially in 



A MEMOIR OF DR. JOSEPH PARRISII. 417 

those elementary branches of medicine which, though apt in their 
minutiae to escape the recollection of practitioners, are neverthe- 
less indispensable to the student as the basis of all professional 
knowledge. The extent of this aid was gradually increased, till 
at length courses of lectures were delivered every year upon 
chemistry, anatomy, and materia medica, to which midwifery 
was afterwards added ; as he himself never cultivated this branch 
of our art, and did not feel himself competent to teach it. Be- 
sides lectures, a regular series of minute examinations upon all 
the different branches was also instituted ; so that a complete 
system of private instruction sprang up under his hands, which, 
if not antecedent to others of a similar character, was certainly 
original with himself and those who assisted him. Dr. Parrish, 
therefore, may be looked upon as one of the founders of that 
combined and more thorough scheme of private medical tuition, 
which constitutes a distinguishing professional feature of our 
city and our times ; and, upon this ground alone, would have 
claims to a most favourable place in our recollections.* 

He sustained this system of medical instruction, with a number 
of pupils, varying from about ten to thirty, till the year 1830, 
when he yielded to the influence of an institution conducted upon 
a plan somewhat similar to his own, but combining the talent 
and professional weight of some of the most prominent phy- 

*I have learned, since delivering the address, that the priority in the 
establishment of the combined system of private medical instruction 
alluded to in the text, belongs to Dr. Chapman, of the University of 
Pennsylvania. He associated Dr. Horner with him in the instruction of 
his private pupils in the year 1817 ; while the first step was not taken by 
Dr. Parrish till 1818, when he engaged my assistance. The statements, 
however, in the address are, I believe, literally correct ; for, to the best 
of my knowledge, Dr. Parrish, at the time he commenced, was not aware 
that a similar arrangement had been made by any other individual. — Note 
to the address when first published. 

27 



418 A MEMOIR OF DR. JOSEPH PARRISH. 

sicians of this city, of whom, moreover, several had the advan- 
tage of being connected with the most flourishing medical school 
in the country. 

But his peculiar abilities as a lecturer were not yet lost to the 
medical community. An association of physicians was formed, 
called the " Philadelphia Association for Medical Instruction," 
at the head of which he allowed his name to be placed, and in 
which he continued to labour faithfully as long as it existed. 
The object of this association, as many of you well know, was 
not to compete with the public schools, but merely to afford to 
the private pupils of the members those advantages which were 
enjoyed by others, and which it was not in the power of any one 
individual to bestow. It continued in successful operation for 
about six years, when it was dissolved in consequence chiefly 
of the advancing age of its main supporter, who began to feel 
that he had borne his share in the burdens of the day, and was 
justified in withdrawing from a portion at least of those labours, 
which, though they had not surpassed his energies or will in the 
prime of his life, began now to press heavily upon him. 

Let us here pause, for a few minutes, to consider his position 
at that period when his mental and corporeal powers were in 
their greatest vigour, his reputation at its height, and all his 
faculties in the fullest exercise. Few individuals have held in 
this city a more enviable station. His professional business 
equalled his highest wishes both in character and amount, lying 
chiefly among the most respectable inhabitants, and being 
scarcely short of his utmost physical capabilities. He was in 
the frequent receipt of letters from various parts of the Union, 
requesting professional advice ; persons often came from great 
distances on purpose to consult him in obscure and difficult cases ; 
and such was his reputation out of the city, that his aid in con- 
sultation was habitually sought by numerous physicians in all 
directions around Philadelphia, and not unfrequently at such 



A MEMOIR OF DR. JOSEPH PARRISII. 419 

distances as to render compliance impossible. With his medical 
brethren at home he was upon the most friendly footing, enjoy- 
ing in a remarkable degree their respect and confidence, and 
constantly consulted by them when additional aid was required. 
When we recollect that, to this great mass of private business, 
there were added a regular attendance as surgeon in our two 
great public hospitals, and the delivery of two courses of lectures 
in each year to his private pupils, we shall be prepared to under- 
stand that his time was fully occupied in active duties, and that 
little opportunity was afforded him for relaxation, or social 
enjoyment. 

But, though occasionally oppressed with the weight of these 
various cares, he experienced that high gratification which 
always springs from the full exercise of our powers, when 
accompanied with the consciousness that they are properly 
directed, and often observed to his friends that he had never, on 
occasion of the severest trials, even for a moment, repented that 
he had devoted himself to the profession of medicine. He was 
cheered, moreover, by the affectionate kindness which every- 
where met him, and which was but a just return for that general 
benevolence with which his own breast overflowed. Almost 
universally known, he never appeared in the streets without 
meeting the grateful and cordial greeting of persons indebted to 
him for life, or health, or some other blessing ; and in every sick 
chamber which he visited, his own bright smile was reflected 
from every countenance not overwhelmed with anxiety or grief. 
Affection beamed cheerfully upon his daily round ; and the kind- 
nesses which he scattered like flowers along his path, returned 
in delicious fragrance to his own gratified sense. He enjoyed 
exceedingly those intervals of business in which he could unbend 
himself in the company of his family and friends ; and the 
sweetness of his temper, the cheerfulness and naivete of his 
manner, his fund of pleasing anecdote, and the goodness of heart 



420 A MEMOIR OF DR. JOSEPH PARRISH. 

which shone forth in all that he said and did, rendered him, on 
such occasions, the source of even greater gratification than he 
received. The social circle which habitually met at his house 
was, indeed, a happy one ; and they who have mingled in it will 
often recall its calm and innocent, yet vivid enjoyments, with a 
sigh that they are passed, and cannot return. 

Though occupied as we have seen, Dr. Parrish found time to 
contribute various medical and surgical papers to the journals, 
all of which are characteristic of his practical turn of mind, and 
some highly valuable. They are contained chiefly in the Eclectic 
Repertory, of which he was one of the editors, and in the Xorth 
American Medical and Surgical Journal. Among them may be 
mentioned, as worthy of especial attention, "Observations on a 
peculiar catarrhal complaint in children, 11 "On infantile con- 
vulsions arising from intestinal spasm, 11 "On affections of the 
mammae liable to be mistaken for cancer, 11 " On pulmonary con- 
sumption, 11 and "On the connection between external scrofula 
and pulmonary consumption. 11 His remarks on the last-men- 
tioned disease are highly interesting, not only from their in- 
trinsic value, but also from the fact, that his views in relation 
to its treatment were justified by the result in his own case. 
Attacked when a young man by a complaint of the chest which 
he believed to be of a consumptive character, instead of confining 
himself to his chamber, and going through a long course of medi- 
cine, as was then fatally common, he adopted the plan, which he 
always recommended to his patients, of vigorous exercise in the 
open air. Most of you recollect the unpretending vehicle, in 
which he was accustomed to pay his daily professional visits. 
It was without springs, and its jolting movement over our rough 
pavements was anything but comfortable to its occupants. This, 
however, was its recommendation with the Doctor, who thus 
imitated, as nearly as possible, the effects of horseback exercise, 
and combined the pursuit of health with that of business. It is 



A MEMOIR OF DR. JOSEPH PARRISH. 421 

scarcely necessary for me to say that he entirely recovered from 
his pectoral affection. After his death, dissection revealed tuber- 
culous cicatrices in the upper portion of each lung, and thus 
proved both the correctness of his diagnosis, and the efficacy of 
his plan of treatment. Were time allowed me, I might here 
expatiate with advantage upon his opinions and practice in con- 
sumption, and in various other complaints ; but this office must 
be deferred to another opportunity, if not to another hand. It 
will' at present be sufficient to state, in addition, that he repub- 
lished Lawrence on Hernia, with an Appendix, and, a few years 
before his death, put forth a work of his own upon Hernia and 
Diseases of the Urinary Organs. 

In the midst of his private engagements, he participated 
largely in the proceedings of those medical associations whose 
constitution and objects he could cordially approve. He was 
long an active member of the College of Physicians, in which he 
held successively the offices .of secretary, censor, and vice-presi- 
dent, and in all whose transactions he took a lively interest. Of 
the Society, moreover, which I have the honour to address, he 
was a zealous member, and, at the time of life in which we are 
now considering him, was one of the most efficient speakers. 
They who are old enough to remember the highly animating 
scenes, which took place in the Medical Society about twenty 
years since, cannot have forgotten the prominent share in the 
debates taken by Dr. Parrish, nor the life and vigour, yet perfect 
good nature and amiableness, which characterized his style of 
speaking. His undaunted opposition to the assaults, which the 
theory of Broussais was then making upon the old medical 
opinions, was fruitful in interest and results. It was on one of 
these occasions that he brought before the Society the stomachs 
of recently slaughtered animals, to show that those post-mortem 
appearances which had been considered as proofs of pre-existing 
inflammation, were often present in cases of violent death, occur- 



422 A MEMOIR OF DR. JOSEPH PARRISH. 

ring in perfect health. He was for some time vice-president of 
the Medical Society. That he did not hold a higher station was 
owing to an invincible repugnance, on his own part, to stand in 
the way of what might be considered the just or reasonable claims 
of others ; and not only here but in all other places, he would 
accept of no office, the access to which must be over the disap- 
pointed hopes, or wounded feelings of a medical brother. 

But his sympathies were not confined within the limits of his 
profession. He took a lively interest in the concerns of the com- 
munity in which he lived, and, whenever opportunity appeared 
to offer for useful interposition, was not slow in contributing his 
share either of advice, of personal service, or of money. He 
occasionally sent anonymous communications to the daily papers, 
in relation to objects which he deemed it important to press upon 
the public attention, especially such as seemed to fall peculiarly 
within the province of the physician. Among these communica- 
tions may be mentioned a series of essays published in the Vil- 
lage Record of West Chester, in this State, in which he endeav- 
oured to point out to the country people the various sources of 
miasmata existing in the decaying vegetation around them, as 
well as the best means of preventing the production of these 
effluvia, and of obviating their effects. 

A strenuous advocate, on all occasions, for the rights of his 
fellow-men, he suffered no motives of present convenience to pre- 
vent him from interfering by word and deed whenever he be- 
lieved these rights to be invaded. The wrongs of the poor 
Indian were not unfrequently the subject of his pen ; and his 
sympathy for the degraded negro was ever active, though pre- 
served by his sound judgment within the bounds of propriety. 
Like all the members of his sect, an uncompromising opponent 
of slavery, he never hesitated to express his sentiments upon the 
subject, nor to yield his aid and counsel in individual cases. He 
was long a member, and ultimately president of the old Penn- 



A MEMOIR OF DR. JOSEPH PARRISH. 423 

sylvania Abolition Society, in which office he had been preceded 
by Drs. Wistar, Rush, and Franklin ; was one of the committee 
deputed by the yearly meeting of his religious associates, to lay 
their views and hopes in regard to slavery before Congress ; and 
was selected by the eccentric John Randolph, when on his death- 
bed in Philadelphia, to be a witness of his last wishes in relation 
to his slaves, and, as a necessary consequence, to be the organ 
of these wishes before the courts of Virginia. For the due per- 
formance of the offices thus imposed upon him, he was peculiarly 
qualified ; as, with the firmness which enabled him to adhere 
unswervingly to what he believed to be truth and justice, he 
combined a suavity of manner, a benevolence of feeling, an open- 
ness of character, and an obvious singleness of purpose, which 
disarmed hostility, and disposed even those who were most 
averse to his views, to admire and love him as a man. 

The same benevolence which impelled him to the relief of the 
helpless and oppressed, caused him to incline to leniency in pun- 
ishment ; and, ever ready to forgive an injury to himself indi- 
vidually, he was prone also to forgiveness in his social capacity, 
at least was accustomed, in doubtful cases, to lean strongly to 
the side of mercy. He shared fully in that aversion to the 
taking of human life which is almost universal among the 
Friends, and carried on a newspaper controversy with a learned 
divine upon the subject of capital punishments, in which he 
endeavoured to show, by reference to the original Hebrew, that 
the Scriptural authority claimed for them was without founda- 
tion, while he maintained their inexpediency, and their contra- 
diction to the whole tenor of Christian morals. In the cases of 
individuals on trial for crimes, or already convicted, he was dis- 
posed to give the most favourable interpretation to every equivo- 
cal point, and experienced the highest satisfaction when able, in 
his medical capacity, to screen suspected innocence, or consci- 
entiously to interpose between a sentence of doubtful justice and 



424 A MEMOIR OF DR. JOSEPH PARRISH. 

its execution. In the instance of the maniac Zimmerman, who 
was confined at Orwigsburg under sentence of death for killing 
his daughter, he was one of a committee of the College of Phy- 
sicians, appointed at his own motion, to visit and examine the 
prisoner; and was thus instrumental in saving a fellow-being 
from unmerited punishment, and the authorities from the guilt 
of a judicial murder.* 

* The following anecdote is so strikingly illustrative of Dr. Parrish's 
mode of thinking and acting in criminal cases, that I cannot deny my- 
self the satisfaction of inserting it here in the form of a note. A family 
consisting of numerous persons became suddenly ill, after partaking of a 
meal, and exhibited all the characteristic marks of poison. One of the 
family died, and dissection confirmed the evidence of the symptoms. Sus- 
picion fell upon a female servant, whose character, upon investigation, did 
not turn out to be in her favour. Though no proof of her guilt existed, a 
strong disposition was evinced to implicate her in the crime. Such was the 
hostile feeling excited towards her, that the coroner's inquest, which sat 
upon the case, needed but the slightest countenance from the physicians to 
bring in a verdict against her. Dr. Parrish believed it to be his duty to 
shield her from any possible injustice. He, and another medical gentle- 
man who was in attendance, testified that both the woman and a child of 
hers were affected in the same manner with the rest of the family. It was 
urged in reply that she had feigned sickness, and had deceived the physi- 
cians. It suddenly occurred to Dr. Parrish that, in all the cases which he 
had examined, there was a white furred tongue. He stated this fact to the 
jury, and proposed that they should examine the tongues of all who had 
been affected. This was assented to, and a display of tongues was accord- 
ingly made. It was found that those of the woman and her child were at 
least as heavily furred as any of the others. The jury was satisfied, and 
refused to implicate her in their verdict. This, however, did not satisfy 
the family. Such a statement was made before a magistrate, that the poor 
woman was arrested and thrown into prison, where she remained several 
months awaiting her trial. Upon being brought before the grand jury, 
she was discharged, for want of testimony, on a verdict of ignoramus. 
— Note to the address when first published. 



A MEMOIR OF DR. JOSEPH PARRISH. 425 

Nor was his attention restricted exclusively to secular affairs. 
A zealous member of the church to which he belonged, and in 
which, towards the close of his life, he accepted the office of elder, 
he participated in all its business, entered with spirit into its 
controversies, and wrote much in relation to its interests and its 
tenets. It is well known, I presume, to all who hear me, that 
not many years since a division occurred in the Society of 
Friends, and that Dr. Parrish took a decided part with that 
section of the society to which he attached himself. Yet, amid 
all the difficulties of the separation, when excitement too often 
counselled violent measures, he was uniformly the advocate of 
peace, and, in his writings, sedulously avoided that strain of 
bitterness which is so apt to infuse itself into theological contro- 
versies, and to leaven all truly religious feeling into its own evil 
nature. It was a source of comfort to him, that most of his 
nearest relatives and friends were of the same mode of thinking 
with himself; and that even with such of them as could not 
coincide with him in sentiment, he yet succeeded in maintain- 
ing an uninterrupted harmony of feeling, springing out of a just 
mutual appreciation of character and worth. 

Such as I have endeavoured to represent them were the va- 
rious engagements which crowded the time of Dr. Parrish, at 
the period of his greatest activity. As he advanced in years, 
the burden which had sat lightly upon his vigorous manhood 
became oppressive ; and, as he was in possession of a fortune 
amply competent to his wants, he began gradually to withdraw 
from the more onerous duties of his profession, and to confine 
his attention chiefly to cases, in which there was less demand 
for active exertion than for the judgment and skill resulting from 
experience. He could not, however, without doing too great 
violence to his feelings, abruptly break off from attendance upon 
those who had long intrusted their lives to his care. I have 
more than once heard him quote, as in some measure applicable 



426 A MEMOIR OF DR. JOSEPH PARRISH. 

to himself, a complaint made by Dr. Wistar, when desirous of 
declining business, yet unable to resist the solicitations of his 
old patients, that what had in early life constituted his highest 
hope, was now become his greatest source of discomfort. He 
succeeded, however, in gradually transferring the most laborious 
part of his business to younger and more willing shoulders. He 
first resigned his station in the hospitals, then withdrew by de- 
grees from operative surgery, and finally limited his professional 
occupation to attendance upon families who had long employed 
him, to the performance of a few favourite surgical operations, 
such as those for cataract, strangulated hernia, and diseases of 
the urinary passages, and to consultations with his brother prac- 
titioners, which were always grateful to him, and continued to 
be numerous up to the time of his last illness. 

There was a short period after he had begun to contract his 
business, during which he again put forth all his energies, and 
laboured with the spirit and activity of youth. This was during 
the prevalence of the epidemic cholera in Philadelphia. At the 
approach of this disease, he felt like the veteran warrior, who, 
while resting upon his laurels, hears the distant sounds of inva- 
sion, and rushes once more eagerly to the contest. He was one 
of the most efficient members of the Sanitary Committee, took 
an active share in the organization of the hospitals, and exerted 
his influence effectively in calming the fears, and overcoming the 
prejudices of the citizens, which threatened materially to inter- 
fere with the requisite arrangements. He had himself the 
special charge of an hospital, in which he spent much time in a 
close observation of the disease, in prescribing and even adminis- 
tering to the sick, and in providing in every possible way for 
their comfort as well as restoration to health. Believing that a 
cheerful and confident state of mind contributed much to recov- 
ery, he endeavoured to remove from around the patients, as far 
as circumstances would permit, everything of a depressing or 



A MEMOIR OF DR. JOSEPH PARRISH. 427 

alarming character, and among other means of producing a 
pleasing effect, procured a number of beautiful plants, which he 
distributed about the entrance of the hospital, and in the open 
grounds in the rear. He was at the same time largely engaged 
with private patients and in consultations ; and answered 
numerous letters addressed to him by his former pupils and 
other practitioners seeking for advice, so that his opinions were 
widely diffused, and gave a tone to the practice in many places. 
But when the danger was over, and the health of the city, puri- 
fied by the late storm, became sounder even than in former years, 
he felt himself justified in returning to his previous purpose. 

His life, however, was at no time a life of idleness. Few 
things were more abhorrent to his nature than mental inactivity; 
and, in his last illness, he considered as among his greatest trials 
that debility of mind which he felt to be stealing over him, a few 
days before his close. Even in the intervals of business, his 
intellect was ever active. He has often told me, that many of 
his peculiar views, both general and professional, were the result 
of reflection during his solitary rides from house to house in 
pursuit of his business. His last years, therefore, though less 
cumbered by almost overwhelming engagements than those of 
his earlier life, were still fully and profitably occupied. Besides 
attending to his restricted practice, to his duties as the father of 
a large family and a prominent member of his church, and to the 
care of a not inconsiderable estate, he participated also in various 
public concerns of a useful or charitable character. He was 
especially active in the organization and subsequent manage- 
ment of the Wills' Hospital for the lame and blind ; and was 
president of the board of managers in this institution from its 
commencement to the time of his death. One of his prominent 
enjoyments, in his declining years, was the superintendence of 
arrangements for the setting out in life of his adult children, in 
whose hopes and efforts he largely participated, and in whom he 



428 A MEMOIR OF DR. JOSEPH PARRISH. 

used to observe that he was living over again his own younger 
days. 

Having now followed the current of his life till near its termi- 
nation, let us endeavour to sketch his peculiar mental linea- 
ments, and form a portrait of his character, while still fresh in 
our memory. 

Of the moral attributes of Dr. Parrish, which he derived from 
nature, the two most prominent were, probably, love for his 
fellow-men, and a desire to stand well in their opinions. His 
preceptor, Dr. Wistar, who loved and esteemed him highly, used 
to say, that he had the ambition of Bonaparte and the benevo- 
lence of Howard. In the best sense of the word, he was 
undoubtedly ambitious. It is true that he never sought for 
power, and was altogether indifferent to the distinction of office, 
unless in so far as it evinced the good opinion of those by whom 
the office was conferred. But no man was more desirous than 
he to stand high in the esteem of others, and none felt more 
keenly marks of respect and affection on the one hand, or of dis- 
respect and ill-will on the other. Of this trait in his character 
he was himself fully aware ; and we find him in early life, when 
under strong religious impressions, struggling in secret against 
its tendencies. Among his private notes is the following refer- 
ence to himself, at a time when he was endeavouring to bring 
himself more completely under the influence of that inward light, 
in the supernatural origin of which he believed as firmly as in 
his own existence. " Thou hast certainly been at times divinely 
illuminated ; but alas ! the cares of this world, not its riches so 
much as its honours, how does a desire after them eclipse the 
Heavenly luminary!" He was never unwilling to admit the 
existence of this love of distinction. It constituted, indeed, one 
of his most powerful impulses to action ; and in his case, as it 
will prove to be in that of every other person who may possess, 
and be able to regulate it, was a principle of usefulness both to 



A MEMOIR OF DR. JOSEPH PARRISH. 429 

himself and others. If, under any circumstances, it exceeded the 
proper bounds in the case of Dr. Parrish, it was by the pain 
which it occasioned him when he met with unkind or unjust 
treatment, or was at any time made the subject of injurious 
report. He could not, perhaps, sufficiently, and he certainly 
never pretended to despise unmerited censure. But, though he 
suffered from this cause, he never allowed it to influence his 
actions, and few have ever been more ready to forgive an injury, 
or to return good for evil. 

But benevolence was a still more striking trait in his char- 
acter. His good-will to all around him was observable in almost 
every movement. Towards those in suffering it was peculiarly 
conspicuous. Hence the charm of his deportment in the sick 
chamber. Nothing could surpass the beautiful kindness of his 
manner towards the sick poor whom he attended. He spoke to 
them in the most friendly tones, soothed their anxieties, respected 
their innocent prejudices, and, in his rounds in the hospitals, uni- 
formly had regard to their feelings, avoiding, in his clinical 
remarks, whatever could wound their sensibility, or excite need- 
less alarm. They who have walked the hospitals with him must 
recollect how the countenances of the patients were lighted up 
at his approach, as if they viewed in him not only their physician 
but their friend. He used to relate frequent instances of their 
grateful remembrance of his kindness, and never joined in that 
. very common complaint of the ingratitude of the poor for medi- 
cal services ; an ingratitude often resulting from a coldness or 
harshness of manner on the part of the physician, which leaves 
the impression that the service was performed merely as a 
matter of duty, and could claim only a corresponding reward. 
The practice of operative surgery occasioned him often great 
distress, especially in children, upon whom he never inflicted 
pain without appearing to suffer it in his own person ; and 
operations in infantile cases became at length so distasteful to 



430 A MEMOIR OF DR. JOSEPH PARRISH. 

him, that he avoided them whenever he could do so with pro- 
priety. 

Nor was the benevolence of Dr. Parrish merely of a passive 
character. It was, on the contrary, highly practical. Not only 
was he liberal with his purse on every suitable occasion, which 
is the easiest mode of charity to one who possesses the means, 
but contributed freely also his time and service, both profession- 
ally and otherwise. No physician in Philadelphia, I presume, 
has attended more patients gratuitously than Dr. Parrish. He 
was peculiarly cautious not to burden the slender means of those 
who, from comfortable or affluent circumstances, had been brought 
into comparative poverty, and were struggling, on reduced in- 
comes, to sustain a decent appearance in the world. When he 
had reason to suspect that any of his patients were in this con- 
dition, he would often endeavour to satisfy himself of the truth 
by the most delicate means in his power, and would then con- 
trive, in the manner least offensive to their feelings, to avoid 
receiving compensation for his services, without leaving behind 
an oppressive sense of obligation. He never, on any occasion, 
exacted payment of a medical fee ; and so strong was his aver- 
sion to compulsory modes of collecting debts of this nature, that 
in his will he expressly and strictly enjoined on his executors to 
put no claim on account of medical services into legal suit. He 
made it a point not to charge for attendance in cases of injury 
received by firemen in the discharge of their duty. For at least 
twenty years, he was in the daily habit of receiving patients at a 
certain hour ; and, as he was well known never to refuse advice, 
and never to charge those who eould not afford to pay him, 
crowds flocked to his house, which, on such occasions, often 
resembled a public dispensary rather than a private dwelling.* 

* The following anecdote, which was told me by an eye-witness, proves 
that his benevolence of character, though it may have been improved by 



A MEMOIR OF DR. JOSEPH PARRISH. 431 

His conscientiousness was not inferior to his benevolence, and 
the two often co-operated to the same end. Hence it was that 
cruelty, oppression, and every form of injustice were so abhorrent 
to his nature. Almost the only occasions upon which I have 
seen him really indignant, were those in which he conceived the 
rights of the weak to be invaded by the strong, or injuries in- 
flicted where there was no power of resistance or redress. Per- 
haps his sensitiveness on this point, may sometimes have led 
him into misapprehension of the motives of others, and a little 
temporary injustice of opinion ; but this was a very slight and 
scarcely sensible counterpoise to the amount of generous feeling 
which was called forth. The same feeling was extended towards 
the brute creation. The animals which he had occasion to use, 
were always treated with the greatest kindness ; and the pro- 
vision made in his will for the old age of a favourite horse, which 
had served him long and faithfully, is generally known. Old 
Lyon was a remarkable brute, and almost as well known in 
Philadelphia as his master. The dog-like docility with which 
he followed at the word of the Doctor, and the sagacity with 
which, when left to himself, he moved off with the vehicle to 
some shady spot in summer, or to some sheltered position in 
winter, were subjects of almost universal remark. 

In all his pecuniary transactions, Dr. Parrish was scrupulously 
just. He did not feel himself authorized to take advantage of 
another in a bargain, and never incurred any responsibility which 

cultivation, was innate. The event occurred, if I remember rightly, when 
he was a boy about ten years old. Meeting a young child in the street, 
during winter, who was carrying something in his naked hands and cry- 
ing bitterly, he put his arms about the little fellow's neck, and finding, 
upon inquiry, that he was suffering from the cold, took his aching hands 
in his own, and having warmed them, put upon them a pair of woollen 
gloves which he had with him, and sent him forward comforted on his 
errand. — Note to the address when first published. 



432 A MEMOIR OF DR. JOSEPH PARRISH. 

he was not fully able to meet. He had insurmountable objections 
to indorsements, on the score of the temptations which their 
facility afforded to extravagant risk, and would never lend his 
name in this way to his nearest friend or relative, preferring 
a direct loan of the money, if in his power, to the loan of his 
credit. 

His conscientiousness was exhibited also in various other ways. 
All those who have studied with him must vividly remember the 
catalogue of evils, incident to the study and practice of medicine, 
called by him his "black list," which he held up to the view of 
young men upon their first application to him as their preceptor, 
so that they might not enter the profession with false views and 
expectations, or at least that no blame might be imputable to 
himself for undue encouragement, should their expectations be 
disappointed. 

In his medical lectures he felt himself bound, in detailing his 
experience, not to conceal his mistakes, so that the pupil might 
have the benefit not only of his successes as an example, but also 
of his missteps as a warning. Few are capable of this mag' 
nanimity, the great majority being satisfied if they tell only the 
truth, without in all cases telling the whole truth. 

One of the most striking instances of the influence of a sense 
of duty over his conduct, was in his declining to take the office 
of professor of anatomy in the University of Pennsylvania, which 
he believed, and I have no doubt upon the best grounds, to have 
been at one time within his reach. I have said that he was 
naturally fond of distinction ; and this was a post to which he 
believed himself competent, and in which he would probably 
have attained much credit, and a wide-spread popularity. An 
ordinary person, in his situation, would have seized upon it with 
avidity. But he regulated his conduct by a higher standard 
than that of personal gratification. He believed that a station 
in the University would bring what might be considered his 



A MEMOIR OF DR. JOSEI>H PARRISH. 433 

duty towards the institution into frequent conflict with his pecu- 
liar religious sentiments and habits. He was unwilling to ex- 
pose himself to temptations, likely to loosen his hold upon those 
principles which he conceived to be the anchor of his safety. To 
his intimate friends, who urged him to avail himself of this 
opportunity, he was wont to answer, in his naive and cheerful 
but impressive manner, by pointing to his breast, and observing 
that he wished to have all comfortable there; that no worldly 
advantages would be any compensation for the loss of that heart- 
felt satisfaction, which attended obedience to the intimations of 
his inward monitor. This was, indeed, the great rule of his 
life. Believing most fully in that fundamental Quaker doctrine 
that the Divine Spirit communicates directly with men, that 
from this source is the "true light which lighteth every man 
that cometh into the world," and that consequently every indi- 
vidual has a sure counsellor in his own breast, which, if consulted 
in the right spirit, will never fail or mislead him, he was in the 
constant habit of looking inward for intimations of duty, and of 
submitting to them implicitly, however opposed to his apparent 
worldly interests. Now, whatever opinion may be entertained 
of these intimations, whether we agree with the Friends in con- 
sidering them as of supernatural origin, or believe them, as most 
men do, to proceed from the natural workings of the mind, under 
the influence of education, habit, reason, and conscience, it is 
nevertheless the fact that, in any case of morals, an individual, 
brought up in a civilized and Christian country, will seldom go 
far astray, who uniformly consults them with a single eye to 
the truth. Dr. Parrish believed that he found peace and safety 
in this rule of action ; and no merely worldly temptation was 
strong enough to remove him from any position which he had 
taken in conformity w T ith it. The same motives which induced 
him to forego the opportunity of obtaining a professorship in the 
University, caused him also to decline offers, and resist solicita- 

28 



434 A MEMOIR OF DR. JOSEPH PARRISH. 

tions afterwards made to him to join other incorporated medical 
schools. " My bark," he used to say, " was made for quiet 
waters." 

Firmness and courage were also among the moral qualities 
which distinguished Dr. Parrish. With all his kindness of heart 
and disposition to please, though no man was less tenacious of 
opinion for opinion's sake, and none more disposed to yield in 
trifles to the convenience or even caprice of others, yet in all 
affairs which involved a point of principle he was immovable, 
and did not hesitate to do or to avow what he believed to be his 
duty, whatever personal injury or odium might accrue. 

Thus morally courageous, he was not wanting in that less 
noble attribute which leads to contempt of danger. During an 
intimate intercourse of many years, I do not remember to have 
seen him, in any one instance, exhibit the least evidence of 
bodily fear. In pestilence he was among the foremost at the 
post of danger. During the prevalence of yellow fever, I have 
seen him by day and by night, without the expectation of pecu- 
niary recompense, and at a period of his professional life when 
he had nothing further to wish for on the score of reputation, 
enter the deserted precincts of infection, and expose himself to 
the most imminent danger, in attendance upon individuals, who 
had been seized by the disease while lingering behind the fleeing 
population. He delighted when young in the excitement and 
hazard of the fireman's duty, and, even at a comparatively late 
period of life, had not entirely relinquished the habit of expos- 
ing his person in great conflagrations. I have known him, in 
times of public tumult, to venture into the midst of the excited 
multitude, and fearlessly oppose his personal influence to their 
mad purposes. On the bed of sickness and death, with a clear 
knowledge of his danger, he was quite composed, and never ex- 
hibited any of those fearful apprehensions which sometimes 
beset the closing scenes even of those best prepared to die. 



A MEMOIR OF DR. JOSEPH PARRISH. 435 

Such, indeed, was his natural temperament, that danger, at- 
tended with the opportunity for exertion, seemed to have charms 
for him ; and I have heard him more than once say, not in a 
boastful spirit, but quite naturally, as if merely giving expres- 
sion to the feelings of the moment, that were he not opposed on 
principle to all wars and fightings, he should take a stern de- 
light, in a cause which he could approve, in leading the forlorn 
hope of an assault. 

In relation to his intellectual faculties, Dr. Parrish was char- 
acterized by quick perception, an excellent memory for facts, 
and an unusual correctness of judgment. Little that he had the 
opportunity of hearing or seeing escaped his observation, and 
what he had once stored up in his mind was ever afterwards at 
his command. He had, therefore, a fund of anecdote and mate- 
rial for illustration, which rendered his conversation highly in- 
teresting as well as instructive, and gave him great advantages 
as a lecturer. He had little imagination, and was without the 
taste and perhaps the ability for abstract and speculative reason- 
ing, which too often busies itself in constructing edifices of con- 
clusion upon slender premises, and wastes in vain attempts to 
establish general truths the time which would be better spent in 
collecting facts. But he was gifted, in an extraordinary degree, 
with that practical faculty which turns to useful account what- 
ever comes within its reach ; which, by a sort of intuition, dis- 
tinguishes a truth amidst the rubbish by which it is concealed, 
and out of a labyrinth of conflicting means selects that which 
most surely leads to the end in view. His was, indeed, emi- 
nently a practical mind, looking always to acts rather than to 
opinions, and disposed to measure the value of any system or 
project by its probable bearing on the condition of society or in- 
dividuals, not by its mere beauty, or the ingenuity displayed in 
its invention. 

But, while thus marked with striking traits, he was not with- 



436 A MEMOIR OF DR JOSEPH PARRISH. 

out the graces also of character. His amiableness of temper, 
candour and openness of heart, liberality of sentiment, charity 
for the failings of others, warmth and constancy in friendship, 
and love of order and punctuality, were often beautifully illus- 
trated in his daily intercourse, and contributed to give him the 
charm of manner which rendered his presence everywhere so 
acceptable. The real politeness for which Dr. Parrish was re- 
markable, was in no respect the result of cultivation, but flowed 
directly from the fountain of his own kindly feelings. It was 
the genuine coinage of nature, which art may counterfeit, but 
seldom equals. With a self-possession resulting from his utter 
want of pretension, and the perfect simplicity of his character, 
and entirely free from that sort of diffidence of manner which is 
the frequent result of pride, he was never awkward in speech or 
movement, and in all the intercourse of life exhibited the deport- 
ment of a true gentleman. 

To the present audience, it is scarcely necessary to recall the 
personal characteristics of Dr. Parrish ; his fine, open, benevo- 
lent countenance, with small but expressive eyes, beautiful teeth, 
and generally regular features ; his form rather below the 
medium height and slightly stooping, but broad, full, well made, 
and vigorous; his gait rapid and energetic, as if in the eager 
pursuit of some important object; his garb, that of the sect 
to which he belonged, and simple according to its strictest 
requisitions. 

Having thus endeavoured to portray our late friend as a man, 
we are next to consider him in his professional capacity as a 
physician and a medical teacher. In the narrative of his pro- 
gress in life already given, allusion has been so often incident- 
ally made to those traits of his character which distinguished 
him as a practitioner of medicine, that comparatively little need 
be said on the present occasion. That little may be included 
under the several heads of his relations, first, to the disease, 



A MEMOIR OP DR. JOSEPH ^PARRISH. 437 

secondly, to the patient, and thirdly, to his fellow-members of 
the profession. 

He was peculiarly skilful in diagnosis. His acuteness of ob- 
servation led him often to notice symptoms or circumstances, 
which, though apparently trifling, and therefore liable to be 
overlooked by a careless eye, were yet of the highest import- 
ance towards the formation of a correct notion of the disease. 
He was at the same time careful not to decide rashly in doubt- 
ful cases, and was especially cautious in surgical affections, in 
which a hasty opinion might lead unnecessarily to serious ope- 
rations. An instance of his acumen in diagnosis, familiar to 
most of his pupils, deserves perhaps to be mentioned here. He 
was invited to be present at an operation for the removal of a 
cancerous tumour of the breast. The surgeons had met, and 
the operator was about to proceed, when Dr. Parrish, having 
made an examination, and been induced to suspect the existence 
of a deep-seated scrofulous abscess, mentioned privately his 
views of the case, and suggested that, previously to the use of 
the knife, a lancet should be thrust deeply into the tumour. 
This was assented to, as at all events a safe expedient, though 
rather in compliance with the wish of the Doctor than from a 
conviction of its propriety. A puncture was accordingly made, 
and a copious flow of pus followed the withdrawal of the in- 
strument. The patient was thus saved a painful operation, and 
the surgeon the no less painful mortification which would have 
ensued, had he attempted the extirpation of the tumour, and 
found himself in the midst of an abscess. 

The extensive experience of Dr. Parrish, and his tenacious 
memory, enabled him frequently to pronounce promptly, in cases 
considered doubtful, by recalling others of a similar nature which 
had occurred to him ; and this process of inference by compari- 
son was so rapid, that his conclusions often appeared, to himself 



438 A MEMOIR OF DR. JOSEPH PARRISH. 

perhaps as well as to others, the result rather of intuition than 
of an intellectual operation. 

A few years since, there appeared in the lower parts of our 
city numerous cases of a disease, which bore some resemblance 
to the common nervous or typhoid fever, but was more violent, 
and presented pathological characters which seemed to mark it 
as a quite different affection. Dr. Parrish was consulted, and at 
once pronounced the disease to be the same typhus fever of 
which he had seen so much when it prevailed here epidemi- 
cally in 1812, and subsequent years, but which had for a long 
time almost wholly disappeared. The result of the treatment 
in these cases confirmed the correctness of the diagnosis. Ac- 
tive stimulation was found to be requisite ; while bleeding, 
which is often well borne in the ordinary typhoid fever, was 
seldom admissible.* 

His correct judgment also was eminently serviceable to him 
in the investigation of disease. Though few circumstances con- 
nected with any case escaped his observation, yet, so far from 
being embarrassed by the multitude of different and often seem- 
ingly conflicting materials for an opinion, he had the talent of 
throwing out of view all but the important points, and was thus 
enabled to come to a satisfactory and usually just conclusion, 
when others of equal or superior knowledge, but less accuracy 
of judgment, were left in uncertainty, or led into error. 

The same good sense caused him to look always to the prac- 
tical and useful in his estimate of disease. Though willing to 
explain facts in the manner which appeared to him most conso- 

* The diagnosis was positively confirmed by a careful comparison of 
the symptoms and course of the two affections, and by the results of 
post-mortem examinations. It was, indeed, through the investigations 
made at this period, that Dr. W. ~W. Gerhard was enabled to establish 
the diagnosis between typhus and typhoid or enteric fever, and to 
determine the distinct nature of the two affections. [December, 1859.) 



A MEMOIR OF DR. JOSEPH PARRISH. 439 

nant with reason, he was utterly averse to mere speculation, and 
never allowed a theory, however plausible, to exert any influence 
over his decisions, when extended beyond the limits of rigid ob- 
servation into the fields of mere conjecture. To the medical 
doctrines which arose in rapid succession during his life, and 
which, in some instances, exerted a wide-spread and not innox- 
ious influence over the profession, he opposed a steady and active 
resistance, believing it to be his duty to protect not only himself, 
but others also, so far as lay in his power, from their fascinations. 
It was not that he disliked them merely as novelties. On the 
contrary, no one seized on newly-announced facts, or well-at- 
tested observations, more eagerly than himself; and ancient 
hypotheses had no more favour in his eyes Ihan those of recent 
origin. But he was convinced that no general theory of disease 
can be true, because we are not yet in possession of the materials 
out of which to form such a theory, and it has not been given to 
man to penetrate by conjecture the counsels of creative wisdom; 
and he believed that false hypotheses are productive of the most 
dangerous practical results. He was in favour, therefore, of 
patiently making and recording observations, and only then at- 
tempting to deduce general truths, when the facts accumulated 
were sufficient for the purpose, without the necessity of a resort 
to supposition or conjecture. Happily, he lived to see this sys- 
tem of prosecuting medical inquiry become the fashion among us ; 
and I have no doubt that, so far as concerns this place, the result 
may in some measure be ascribed to his efforts. 

The peculiar intellectual qualities which aided him in the study 
of disease were no less useful to him in therapeutics, in which 
also he exhibited the same preference of experience over the sug- 
gestions of abstract reasoning, or the inventions of imagination. 
Though by no means distrustful of the powers of medicine, he 
yet had great confidence in the native resources of the system, 
and was much in the habit of relying on them in his course of 



440 A MEMOIR OF DR. JOSEPH PARRISH. 

treatment. He watched carefully for the indications which 
nature might present, and not unfrequently answered these in- 
dications, though opposed to general opinion, or even to his own 
preconceived views. He attached great importance to the con- 
stitutional peculiarities of individuals, which he studied with 
care, and alwavs consulted in his choice of remedies. The ordi- 
nary means by which life and health are sustained, such as pure 
air, cool drinks, wholesome food, a regulated temperature, exer- 
cise, etc., frequently became in his hands powerful therapeutical 
agents, especially in cases which seemed to have originated 
in the want of them. Yet when medicines appeared to be de- 
manded, he was prompt and efficient in their use ; and was often 
very happy in the selection of those best adapted to the case, 
being greatly aided in his choice by a peculiar sagacity, which 
suggested new modifications or contrivances to meet unforeseen 
emergencies, or unusual states of disease. 

To the practice of surgery he was admirably adapted by these 
same qualities, and, in addition, by those essential physical re- 
quisites, a good eye, a steady hand, and general firmness of nerve. 
I never but once saw his hand tremble under any circumstances 
of health or sickness. He used to have some pride in this im- 
portant surgical qualification ; and I have frequently seen him, 
even when exhausted by severe and long-continued illness, hold 
out his hand in the position in which it was wont to grasp the 
knife, without the slightest discoverable motion other than that 
produced by the arterial pulsations. He used to say that, when 
he should perceive his hand to shake under these circumstances, 
he should consider it as an evidence that he was near his end ; 
and surely enough, in his last illness, a very short time before 
his death, while he was almost unconsciously repeating the same 
trial of his strength of nerve, I observed for the first time that 
failure which he considered so ominous. 

Towards the sick the deportment of Dr. Parrish was most 



A MEMOIR OF DLt. JOSEPH PARRISH. 441 

happy. The cheering- smile with which he accosted his patients, 
his soothing kindness, his encouraging and confident manner 
while there was still ground for hope, and his affectionate sym- 
pathy aud consolation w T hen hope was over, remain indelibly 
impressed on the grateful recollections of thousands in this city. 
In dangerous cases, he was candid whenever there was not 
reason to fear that by being so he might greatly aggravate the 
danger; and he never undertook a hazardous operation, without 
having previously made the patient acquainted with his con- 
dition, and obtained his consent, with a full knowledge of the 
possible consequences. When thus called upon to be the herald 
of danger, the kindness of his heart pointed out the mode of pro- 
ceeding least likely to occasion unnecessary pain ; and his well- 
known character as a pious man enabled him to mingle very 
effectively the consolations of religion with the gloomy intelli- 
gence which he had to announce. He was frequently consulted 
by his patients, in the capacity of a friend and counsellor as well 
as physician, and thus became the confidant of many private con- 
cerns, which he always considered as a sacred trust committed 
to his honour. He was scrupulously careful never to violate 
professional confidence. Nothing ever passed his lips which 
could affect the reputation of those who had placed themselves 
in his hands ; and, when there was something in a case inter- 
esting in a professional point of view, which, however the patient 
might wish to be concealed, he was most cautious, in relating the 
fact for the benefit of his pupils, not to mention the name, and 
even to avoid every allusion which could by any chance connect 
the event with the individual. When such a connection was 
unavoidable he was entirely silent ; for he considered that no 
good which might possibly accrue to society from the publica- 
tion, or promulgation in any way, of any particular case, could 
justify a physician in violating even an implied trust. Upon his 
students he was always exceedingly solicitous to inculcate the 



442 A MEMOIR OE DR. JOSEPH PARRISH. 

great importance of professional secrecy, not only as essential to 
the respect of the world, but as in the highest degree binding 
upon their honour and conscience. 

I have already spoken of his liberality towards patients of 
slender means, and the delicacy with which his favours were 
conferred. This conduct arose from feeling and principle, and 
not from mere carelessness in relation to pecuniary concerns ; 
for in all his business transactions he was scrupulously exact, 
and, in relation to his fees for medical services, considered it a 
duty which he owed as much to his patients and the profession 
as to himself, to present his accounts regularly once a year, when- 
ever peculiar circumstances did not require some relaxation of 
his general rule. He always, however, considered these ac- 
counts in the light of honorary claims, and not only never exacted 
payment, but declined it altogether when the patient expressed 
any doubt of its justice, or any great unwillingness to discharge 
it. I recollect being present, on one occasion, when a country- 
man of some wealth, and no less covetousness, called at his 
house to settle a bill for medical attendance. He was probably 
not accustomed to the rate of charging common in the city, and 
demanded some abatement from the account on the score of its 
extravagance. The Doctor in reply told him that if such were 
his views, he should decline receiving anything ; whereupon the 
gentleman, commending his liberality, took up his hat and left 
the house, apparently very well contented. 

Perhaps in no respect did Dr. Parrish appear to greater ad- 
vantage than in his relations with his medical brethren. It was 
one of his maxims that no physician could have a satisfactory 
professional standing, who disregarded the good-will and good 
opinion of his fellow-practitioners. He was, therefore, mindful 
of their rights on all occasions, never allowing any chance of 
immediate or prospective advantage to himself to interfere with 
their just interests, and very often going out of his way to pro- 



A MEMOIR OF DR. JOSEPH FARR1SH. 443 

tect their reputation, and to repair any injury they might have 
suffered in the estimation of their patients. He held in abhor- 
rence that meanness of spirit which, for a little apparent profit, 
would insinuate evil of a brother, or even assent by silence to a 
mistaken estimate of his worth. He was strictly obedient to 
the ethical code, which wise and good physicians have estab- 
lished for the regulation of their intercourse with their patients 
and with one another, and which, however liable to reproach 
from selfishness or inexperience, is yet indispensable to the main- 
tenance of harmony in our profession, and consequently to effi- 
ciency for the public good. No medical man could long remain 
in a hostile attitude towards Dr. Parrish. I do sincerely believe 
that he never purposely gave cause of offence to a fellow-prac- 
titioner ; and any temporary ill-will, which may have originated 
in misconception, soon melted away before his amenity of man- 
ner and obvious goodness of heart. He never resented an injury, 
real or supposed, and not unfrequently repaid unkindness with 
benefits. 

From his regard for his fellow-practitioners, it may be inferred 
that he had pleasure in meeting them in consultation. He had 
none of the jealous} 7 * which fears a rival in every person with 
whom we may be associated in attendance, nor of the over- 
weening and arrogant self-esteem which owns no fallibility of 
judgment. It was his custom, whenever he supposed a patient 
or his friends might desire additional aid, or when the case was 
one of a doubtful or embarrassing nature, to offer a consultation ; 
and when a suggestion to this effect came from the patient him- 
self, he always promptly gave his assent, however inferior in age 
and standing might be his proposed associate. 

Another trait, which favourably distinguished his intercourse 
with the profession, was an extraordinary punctuality in the 
fulfilment of his engagements. In consultations he very rarely 
failed to meet at the time appointed ; and so jealous was he of 



444 A MEMOIR OF DR. JOSEPH PARRISH. 

his character in this respect, that it was a habit with him, which 
most of his medical friends must remember, to present his watch 
when he was second in entering the house, in order to prove that 
he was not after his time. 

Towards the younger members of the profession, he conducted 
himself in a manner calculated to win their affection as well as 
respect. So far from feeling the least touch of jealousy at their 
success, or exhibiting any of that overbearing temper which 
sometimes attends an increase in years and honours, he was 
always gratified with an opportunity of promoting their interests, 
and regulated his intercourse with them upon the same principles 
as with his equals in age. He did not consider the tie between 
himself and his pupils broken, when they had established them- 
selves as practitioners. On the contrary, he felt towards them 
as towards younger brothers, rejoiced in their professional ad- 
vancement, aided them by his advice and recommendation, and 
took every opportunity of causing the superabundance of his 
own cup to flow over into theirs. It was a fine trait in his char- 
acter, and one which has endeared him to many now present, 
that when any of his young friends, through accident or other 
-cause, acquired a footing in families which he had been in the 
habit of attending, instead of feeling unkindly or endeavouring 
in any way to interfere with their interests, he seemed to enjoy 
their success, and took pains to strengthen the impressions in 
their favour, through the influence which his long professional 
intercourse with the families naturally gave him. I know that 
there are many, who will heartily join me in this tribute of ac- 
knowledgment to the memory of our deceased benefactor and 
friend. But I feel that on my own part the tribute is inadequate. 
"When I call to mind his virtues, his many amiable qualities, and 
his numberless acts of personal kindness; how he took me by 
the hand w T hen young, admitted me into his intimate confidence, 
attended me in illness, counselled and aided me when counsel 



A MEMOIR OF PR. JOSEPH PARRISH. 445 

and aid were needed, and throughout life gave me his warmest 
sympathy, my breast is filled with emotions which exceed the 
powers of language, and I cannot but feel, that my efforts to ex- 
hibit him to others with all his admirable characteristics as they 
present themselves before me, are as futile as would be an at- 
tempt, without the talents of a painter, to transfer to the canvas 
the vivid image of his form and features impressed upon my 
memory.* 

A few words in relation to the peculiarities of Dr. Parrish as 
a teacher, will close this imperfect representation of his medical 
character. Without having cultivated either rhetoric or oratory 
as an art, he was a fluent and by no means inaccurate speaker,, 
and, when under the impulse of high principle or strong feeling, 
was often truly eloquent, attracting the fixed attention of the 
audience, and carrying their whole sympathies along with him. 
It appeared as if his own beautiful feelings were personified 
in the speaker, and that the hearers were listening to the very 
voice of benevolence, of charity, of compassion for the weak and 
suffering, of indignation against oppression, or of whatever other 
emotion was at the time predominant within him. On such oc- 

* In view of certain untrue statements which have appeared in print, 
in relation to my earlier life, I may, perhaps, be permitted here to say 
that the aid, referred to in the text, was purely professional. I never 
received, as I never needed, pecuniary assistance from Dr. Parrish. Our 
relations were as nearly as possible, without any blood-connection, those 
of an elder and a younger brother ; at least my feelings of respect and 
affection towards him were such as would naturally arise out of such a 
relation ; and I have reason to think that they were fully reciprocated 
on his side. During our long intercourse, whatever might be our dif- 
ferences of opinion, there was an unbroken intimacy; and, in his last 
illness, he showed his continued confidence by putting himself under my 
professional care, jointly with that of our mutual friend, Dr. John C. Otto. 
{December, 1859.) 



446 A MEMOIR OF DR. JOSEPH PARRISH. 

casions, as he was under no restraint from the rules of art, and 
unembarrassed by the consciousness of any evil in his own 
thoughts, he surrendered himself freely to the current of his 
emotions, which, as they were themselves pure, threw up to the 
surface nothing which required concealment. 

This pouring out unreservedly of all that he thought or felt, 
constituted the main charm also of his medical lectures. His 
instructions did not consist of laboured treatises upon disease, 
presenting in a regular and compact arrangement all that was 
known upon the subject. They were rather vivid pictures of 
his experience, in which the pupil was enabled to see the very 
events as they passed, and to see them too with the trained eyes 
of their preceptor. They were made to enter into the very case, 
to share in the reflections, hopes, and fears of the speaker, and 
thus to take an almost personal interest in the progress and 
termination of the disease. His lessons became in fact to his 
pupils a sort of experience of their own ; and I think it probable 
that many of us, who have been long in practice, would find 
some difficulty in discriminating between the recollection of what 
we have ourselves seen, and the strong impressions left upon our 
minds by the representations of our teacher. 

Through his lectures there ran a vein of cheerful good-nature, 
enlivened with frequent touches of humour, which added much 
to their attractiveness. By his very mode of accosting his pupils 
upon entering the lecture-room, he contrived to place them upon 
a footing of friendly familiarity, which disposed them to attend 
to his instructions out of personal regard for the speaker, as well 
as from a desire to learn. "Well, boys," he would say, prepara- 
tory to some kindly greeting, or some friendly inquiry, and thus 
by a few words expressive of his own good feeling, attuned their 
minds into harmony with his own, and was enabled to carry 
their hearts, as well as their attention, along with him in his 
subsequent address. 



A MEMOIR OF DR. JOSEPH PARRISH. 441 

I 

But the feeling of familiar companionship, with which he 
inspired his pupils by his deportment towards them on all 
occasions, never passed the limits of perfect propriety. It was 
so mingled with reverence for his purity of heart, and elevation 
of character, that nothing but the spirit of evil could have sug- 
gested anything likely to prove offensive to him ; and the guard 
which the student was thus induced to keep over any wrong 
propensity, in the midst of the otherwise unreserved intercourse 
with his preceptor, had the tendency to modify his own character 
favourably, and to make him in reality what he wished to appear. 

In his lectures Dr. Parrish was accustomed to introduce numer- 
ous illustrative cases, and endeavoured to strengthen the effect of 
mere description by the exhibition of pathological specimens, 
which, in the long course of his practice, he had been enabled 
to procure in great numbers. Indeed, his collection of diseased 
bones was probably unequalled in any cabinet, public or private, 
in this country. He strove also constantly to direct the atten- 
tion of his pupils to the practical observation of disease, and to 
the attainment of familiarity with all the instruments and means 
of cure. With the latter view, he recommended them to spend 
some months in the shop of an apothecary, in the earlier period 
of their studies, and to seize every opportunity of performing 
those minor operations, and exercising those manipulations, a 
perfect facility in which is so important to the practitioner, and 
especially to the surgeon. He urged upon them, moreover, a 
regular attendance at the hospitals, and, in his own private prac- 
tice, sought occasions to enable them to see disease, to assist at 
operations, and in various ways to initiate themselves into the 
practical duties for which they were preparing. 

On the whole, few men have, I believe, exhibited a stronger 
interest in their pupils, or laboured more assiduously to promote 
their welfare ; and no one, certainly within my own observa- 
tion, has gained a more ample return of love and respect. 



448 A MEMOIR OF PR. JOSEPH PARRISH. 

Having thus given a historical sketch of Dr. Parrish up to the 
period of bis last illness, and endeavoured to delineate his char- 
acter as a man, a physician, and a medical teacher, it now only 
remains for us to consider him in the closing scene of his life. 
This is the touchstone which tries the value of the past, and dis- 
tinguishes what was sterling worth from the false glitter of pro- 
fession, and the deceptions of self-esteem. He only can be said 
to have been truly happy in life whose end is happy. To the 
friends of Dr. Parrish it is a source of the purest satisfaction, 
that he passed successfully through this last, and severest trial 
and that the close of his career was in harmony with its whole 
course. He was attacked in the summer of 1839 by the disease 
which ultimately proved fatal, but continued to attend to his 
various avocations, though somewhat irregularly, till about the 
beginning of the present year, when he confined himself to his 
house, on account of a severe bronchial affection superadded to 
his former complaint. From this he partially recovered, so as 
to be able to drive out occasionally, and even visit patients ; but 
he suddenlv became worse about the close of Februarv, and, 
taking to his bed, continued to sink gradually for nearly three 
weeks, and died on the 18th of March, in the sixty-first year of 
his age. Though somewhat lethargic towards the conclusion of 
the disease, he was capable, when roused, of thinking with per- 
fect clearness, and of fully appreciating his condition, till a day 
or two before death. In the midst of much bodily distress, and 
great derangement of his nervous system, he preserved unim- 
paired those amiable traits of character by which he was dis- 
tinguished in health, frequently expressing a grateful sense of 
the kindness of those who administered to him, and carefully 
avoiding any expression which could wound their feelings. 
With the full conviction of the fatal character of his disease, and 
with the near prospect of its termination, he was perfectly calm 
and self-possessed, made all the requisite arrangements in his 



A MEMOIR OF DR. JOSEPH PARRISH. 449 

affairs, spoke to his family as a tender husband and father, 
solicitious for their present and eternal welfare, might be ex- 
pected to speak, and uniformly expressed his reliance upon the 
goodness and mercy of Providence, and his hope of a happy 
hereafter. Under the feeling of his utter bodily prostration, he 
used to say to his physicians that he was like a log of wood on 
the Delaware, floating about at the discretion of the winds and 
tides. At one of their latest visits, when hearing and sight 
were failing, and the power of articulation was almost gone, he 
repeated this expressive figure, and could but just be heard to 
say in addition, " but even the log on the Delaware has its care- 
taker." Thus, the reliance upon a superintending Providence, 
which was one of the governing principles of his life, did not fail 
him in death ; and, if love for his fellow-men, unceasing benefi- 
cence, and a reference in almost all that he said and did to the 
will of his Maker, may be considered as the indications of a 
spirit prepared for immortality, his friends may confidently in- 
dulge the belief, that, in dying, he has but exchanged the un- 
certain gratifications of this world for the sure happiness of that 
to come. 

The almost unprecedented array of his fellow-citizens of all 
classes who attended his remains to the grave, the general 
expression of regret for his loss, and the measures taken by the 
various bodies to which he belonged, to procure some public 
commemoration of his worth and services, are evidences of a 
general esteem and affection such as seldom fall to the lot of 
individuals, unconnected with public life. Perhaps no one was 
personally known more extensively in the city, or had connected 
himself, by a greater variety of beneficent service, with every 
ramification of society. It is true that no marble has been 
erected over his remains, and that the very spot where they are 
laid will soon be undistinguishable to every eye save that of con- 
jugal or of filial love ; yet the remembrance which he has left 

29 



450 A MEMOIR OF DR. JOSEPH PARRISH. 

behind him, the only monument which the rules of his unosten- 
tatious sect allow, is far more precious than the praises of carved 
stone, which gold may purchase, or power command. Should 
this humble tribute to his worth add in the least to the bright- 
ness or the duration of that remembrance, the author will feel 
the sweet reward of having paid a double debt, to gratitude and 
to truth. 



A BIOGRAPHICAL MEMOIR 



SAMUEL GEORGE MORTON, M.D., 



READ BEFORE 



THE COLLEGE OF PHYSIC1AXS OF PHILADELPHIA, 

NOVEMBER 3d, 1852. 



In accepting- the appointment with which the College hon- 
oured me, of preparing- a biographical sketch of our late Fellow, 
Dr. Samuel George Morton, it may be remembered that I 
requested indulgence on the score of time ; as the urgency of 
my then existing engagements rendered immediate attention to 
the duty impossible. The delay has been longer than I could 
have wished ; but, happily, there was little occasion for haste r 
as the Academy of ^Natural Sciences, with which, through official 
position and long co-operation, Dr. Morton was more closely 
connected than with any other public body, had already provided 
for that commemoration which society owed to him, as to one 
who had faithfully and honourably served it. In what manner 
this duty was fulfilled need not be told to those who have 
perused the memoir, prepared by Dr. C. D. Meigs, so character- 
istic of the author in its easy and copious flow of expression, its 
genial warm-heartedness, its glowing fancy, and the cordial, 
unstinted appreciation of the merits of its subject. It may be 

(451) 



452 A MEMOIR OF DR. SAMUEL GEORGE MORTON. 

proper to mention here, that to this memoir I am indebted for 
many of the following facts. Having been prepared under the 
auspices of an association devoted to the natural sciences, though 
treating of our departed colleague with greater or less fulness in 
all his relations, it very appropriately directs a special attention 
to the scientific side of his life and character. With equal pro- 
priety, as appears to me, a professional body like the present may 
expect a particular reference to his medical history; and I shall, 
accordingly, endeavour to place him before you, rather as a phy- 
sician than as a man of general science. It was in the former 
capacity that Dr. Morton was best known to the writer, who 
had the honour of aiding in the conduct of his early medical 
studies, was afterwards for a time associated with him as a 
medical teacher, and, throughout his whole professional life, 
maintained with him a frequent and friendly intercourse. 

The delineation which follows is necessarily in miniature ; for, 
independently of the comparatively short time which can be 
devoted to such communications in the business of the College, 
the pages of our journal, to which it is customary in the end to 
consign them, are too limited to receive in its fulness a portrait- 
ure, which might readily be made to occupy volumes. I shall, 
however, endeavour, by excluding irrelevant commentary, and 
by expressing myself as concisely as possible, to introduce within 
the limits assigned the greatest practicable amount of biograph- 
ical matter. 

Dr. Morton sprang from a highly respectable family, residing 
at Clonmel, in Ireland. His father, George Morton, the youngest 
of four brothers, emigrated at the age of sixteen to this country, 
with another brother somewhat older, who soon afterwards died. 
He settled in Philadelphia, and, having acquired the requisite 
experience in a counting-house in a subordinate capacity, after- 
wards engaged in mercantile business on his own account. Here 
he married Jane Cummings, a lady having a birthright in the 



A MEMOIR OF DR. SAMUEL GEORGE MORTON. 453 

religious Society of Friends, which, according to a well-known 
rule of that Society, she lost upon her marriage with one who 
was not a member, Mr. Morton belonging to the English Church. 
He died on the 27th of July, 1799, leaving his widow with three 
children, a daughter and two sons, the youngest of whom was the 
subject of the present sketch, and at that time an infant in arms. 
The older boy, James, was soon afterwards sent to an uncle in 
Ireland, who adopted him ; but he died before maturity. The 
sister still survives to lament the loss of both her brothers. 

Dr. Morton was born on the 26th of January, 1799, and w T as 
consequently about six months old at the death of his father. In 
her bereavement the widow sought consolation in religion, and, 
still entertaining the faith in which she had been educated, ap- 
plied for restoration of membership in the Society of Friends, 
and was received. With a view to be near a beloved sister, she 
removed from Philadelphia to Westchester, in the State of 
New York, but a few miles from the metropolis, where her sister 
resided. Wishing that her children should be brought up in 
her own religious faith, and surrounded in early life by those 
safeguards which are eminently provided by the discipline of 
Friends, she sought for their admission into the Society ; and 
they were accordingly received as if members by birth. 

Custom, if not positive rule, requires among Friends that chil- 
dren should as far as practicable be educated in schools under 
the care of the Society, so that their tender years may be pro- 
tected until their principles shall have sufficiently taken root to 
resist the seductions of the world. As no school of this kind 
existed in her immediate neighbourhood, Mrs. Morton felt her- 
self compelled, when no longer satisfied with her own tuition, to 
send her young son from home ; and, for several years of her 
residence at Westchester, he was placed in one or another of 
the Friends' boarding-schools in the State of New York, where 
he acquired the usual rudiments of an English education. 



454 A MEMOIR OF DR. SAMUEL GEORGE MORTON. 

At this early age, the boy evinced a literary turn of mind, 
being extremely fond of historical reading, and frequently trying 
his hand in writing verses, an exercise very useful to the young, 
by giving them a command of language not so easily attained in 
any other way. I am told that his bent toward natural science 
was also received at this period. Among the visitors of his 
mother was Thomas Rogers, a gentleman belonging to the 
Society of Friends, living in Philadelphia, who had a great fond- 
ness for mineralogy, and imparted a portion of the same fondness 
to the young son of his hostess, whom he delighted to take with 
him in his exploratory walks in the neighbourhood. 

The visits of Mr. Rogers resulted in his marriage with Mrs. 
Morton, and her return with him to Philadelphia, along with her 
two children, whom he loved and treated as if they were his 
own. Dr. Morton always spoke in the kindest and most affec- 
tionate terms of his step-father. He was about thirteen years 
old when this change took place. 

After the removal to Philadelphia, he was sent for a time to 
the famous boarding-school of Friends at Westtown, in Chester 
County, Pennsylvania; and subsequently, in order to complete 
his mathematical studies, to a private school in Burlington, New 
Jersey, under the care of John Gummere, a member of the 
Society of Friends, and eminent as a teacher. 

Having remained for one year under the instruction of Mr. 
Gummere, he left the school, in the summer of 1815, and entered 
as an apprentice a mercantile house in this city, in which he con- 
tinued until the death of his mother in 1816. 

His heart was not in his business; and though there is no 
reason to believe that he neglected the duties of his position, he 
devoted most of his leisure hours to reading, and gave his 
thoughts rather to history, poetry, and other branches of polite 
literature, than to mercantile accomplishment. 

The last illness of his mother was protracted, requiring the 



A MEMOIR OF DR. SAMUEL GEORGE MORTON. 455 

frequent attendance of physicians ; and several of the most dis- 
tinguished practitioners of Philadelphia were in the habit of 
visiting her professionally. Drs. Wistar, Parrish, and Harts- 
horne were men calculated to impress favourably the mind of a 
bright, and at the same time thoughtful youth ; and the atten- 
tions they paid to him, elicited no doubt by their observation of 
his intelligence and studious tendencies, had the effect of greatly 
strengthening the impression. His respect and affection for 
these eminent physicians naturally inclined him to their profes- 
sion, and suggested the wish that he might be prepared to tread 
in their footsteps. This, I am informed, is what first directed 
his thoughts towards the study of medicine ; though, as stated 
by Dr. Meigs, it is not improbable that the reading of the pub- 
lished introductory lectures of Dr. Rush may have been the im- 
mediate cause of his change of pursuit. 

In the year 1817, being in the nineteenth year of his age, he 
entered as a pupil into the office of the late Dr. Joseph Parrish, 
then in the height of his practice, and distinguished as a private 
medical teacher. It was here that I first formed his acquaint- 
ance, being about to close my pupilage under the same precep- 
tor, when he began his. As I was, soon after graduation, en- 
gaged by Dr. Parrish to aid him in the instruction of his rapidly 
increasing class, I had, both as a companion and teacher, the op- 
portunity of witnessing the industry and quick proficiency of the 
young student, and formed a highly favourable opinion of his 
general abilities. He attended the lectures in the University of 
Pennsylvania regularly, and, having complied with the rules of 
the institution, received from it the degree of Doctor of Medi- 
cine, at the commencement in the spring of 1820. 

During the period of his medical studies, he continued to re- 
side with his step-father, and to this association probably owed 
in part his continued predilection for the natural sciences. It 
was to be expected' from such a predilection, that he would give 



456 A MEMOIR OF DR. SAMUEL GEORGE MORTON. 

especial attention to anatomy, which, indeed, he cultivated with 
much diligence and success. Similarity of taste and pursuit in 
this respect, led to a friendly association, about this period, with 
the late Dr. Richard Harlan, who superintended the anatomical 
studies of Dl\ Parrish's pupils, and subsequently became distin- 
guished as a naturalist. 

Soon after his graduation, Dr. Morton became a member of 
the Academy of Xatural Sciences, thus commencing his profes- 
sional career as a member of that body, over which he presided 
at the time of his death. 

Having been pressingly invited by his paternal uncle, James 
Morton, of Clonmel, before commencing the practical duties of 
life, to pay a visit to his relatives in Ireland, and eager to im- 
prove both his professional knowledge and his knowledge of the 
world, he concluded to make a voyage to Europe, and accord- 
ingly embarked for Liverpool in May, 1820. On arriving in 
England, he proceeded immediately to Clonmel, where he spent 
about four months in a delightful intercourse with friends and 
relatives proverbially hospitable, improving in manners through 
the polishing influence of refined society, and cultivating his- 
taste by varied reading. It is probable that, in this association, 
whatever bent his mind may have received, from early educa- 
tion, towards the peculiarities of Quakerism, yielded to the in- 
fluences around him ; for though, throughout life, he reaped the 
advantages of that guarded education, in an exemplary purity of 
morals, and simplicity of thought and deportment, he connected 
himself subsequently with the Episcopal Church, to which his 
forefathers had been attached. 

The uncle of Dr. Morton very naturally valued a European 
degree more highly than an American, and was desirous that 
his nephew, before entering on his professional career, should 
obtain the honours of the Edinburgh University. The Doctor 
yielded to his wishes, and left his Irish friends, to enter upon a 



A MEMOIR OF DR. SAMUEL GEORGE MORTON. 457 

new course of medical studies at the Scotch capital. In conse- 
quence of exposure, in his journey from Dublin to Belfast, on the 
top of a coach, he was seized with an illness, believed to be an 
affection of the liver, which confined him for some time to his 
bed in Edinburgh, and probably served as the foundation of that 
delicacy of health, which attended him for the rest of his life. 
On his recovery, he commenced an attendance upon the medical 
lectures, and at the same time upon those of Geology by Pro- 
fessor Jamison, thus showing that his attachment to natural 
science still continued. 

Another attack of illness, early in the year L821, interrupted 
his studies. Recovering from this, he made an excursion into 
the Highlands of Scotland, and afterwards returned to the relaxa- 
tion and enjoyments of a residence among his friends at Clonmel. 

In the autumn of the same year, he made a journey to Paris, 
where he spent the winter very profitably in the prosecution of 
his studies, and in improving his knowledge of the French 
language. 

In the following spring, he left Paris upon a tour through 
France, Switzerland, and Italy, in which he consumed the 
summer. 

In the autumn of 1822, we find him again at Edinburgh, where 
he continued through the winter, attending lectures, making up 
for early deficiencies in classical education by the study of Latin, 
and otherwise preparing himself for graduation. Having written 
and presented a thesis in Latin, De Corporis Dolor e, and under- 
gone satisfactorily an examination on medicine in the same 
language, he received the honours of the University in August, 
1823. 

He had thus been six years occupied, more or less steadily, in 
the study of medicine, carrying on, during the same period, a 
process of self-education, which more than compensated for the 
deficiencies of his early life, and attaining a proficiency in various 



458 A MEMOIR OF DR. SAMUEL GEORGE MORTON 

branches of natural science, which contributed greatly to his 
future eminence. 

In June, 1824, he bade fare-well to his friends in Ireland, and, 
returning to Philadelphia, immediately engaged in the practice 
of his profession. 

His success was gradual. Young physicians are apt to com- 
plain of their slow progress in a remunerative business ; but what 
they consider a misfortune is in fact, if properly used, a blessing. 
Their early years have been devoted to the acquisition of ele- 
mentary knowledge, their later will be occupied by practical 
duties. It is in the intermediate period that the opportunity is 
offered of extended research into the records of science, of con- 
firming or correcting the results of reading and study by observa- 
tion, of making original investigations into the worlds of matter 
and of thought, and thus bringing forth to the light truths which 
may benefit mankind, and at the same time serve as the basis 
of honour and success to their discoverer. He who leaps at once 
from professional study into full professional action, finds all his 
time and powers occupied in the application of the knowledge 
alreadv attained, and seldom widens materiallv the circle of 
science, or attains higher credit than that of a good, or a success- 
ful practitioner. It was undoubtedly fortunate for Dr. Morton's 
reputation, that his time was not, at the outset, crowded with 
merely professional avocations. He had thus the opportunity 
of going out into the various fields of natural science ; and, while 
he neglected none of the means requisite to the honourable 
advancement of his business as a physician, he pushed his re- 
searches and labours in those fields to the most happy results. 

As an aid and stimulus to his researches in this direction, he 
entered at once into hearty co-operation with his fellow-members 
of the Academy of Natural Sciences, and took an active part in 
the affairs of that institution. He was almost immediately made 
one of the auditors j in December, 1825, was appointed to the 



A MEMOIR OF DR. SAMUEL GEORGE MORTON. 459 

office of Recording Secretary, which he held for four years; 
served actively for a long time on the Committee of Publication ; 
aided materially in increasing and arranging the collections; 
delivered before the Academy lectures on mineralogy and geology 
during the years 1825 and 1826 ; drew up a report of its transac- 
tions for these two years ; and began a series of original papers 
upon various subjects of natural science, which have contributed 
greatly to his own credit, and that of the institution. 

His first medical essay was on the use of cornine in intermit- 
tent fever, and was published in the Philadelphia Journal of the 
Medical and Physical Sciences (xi. 195, ad. 1825). Under the 
name of cornine, a material had been given to him, purporting 
to be an alkaline principle extracted from common dogwood 
bark, and, having been used by him in several cases of intermit- 
tent fever, proved to be an efficacious remedy. Dr. Morton was 
responsible only for the correctness of his own statements as to 
the effects of the substance given to him, and not for its chemical 
character, which must be admitted to be at best doubtful. Posi- 
tive proof is still wanting of the existence of any such active 
alkaline principle. 

His first strictly scientific papers were two in number, both 
read on the 1st of May, 182*7, before the Academy of Natural 
Sciences, and afterwards printed in the Journal of the Academy. 
They were entitled respectively, il Analysis of Tabular Spar, 
from Bucks County, Pennsylvania, ivith a notice of various 
minerals found at the same locality," and "Description of a 
new species of Ostrea, with some remarks on the Ostrea convexa 
of Say." 

These were followed in rapid succession by other scientific 
communications; and the Transactions of the Academy con- 
tinued to be enriched by his labours from this date till within a 
short period before his death. There were not less than forty 
of these contributions, besides others to the Transactions of the 



460 A MEMOIR OF DR. SAMUEL GEORGE MORTON. 

American Philosophical Society, and the American Journal of 
Science and Art, edited by Professor Silliman. They were od 
the various subjects of mineralogy, geology, organic remains,, 
zoology, anatomy, ethnology, and archaeology; and, by their 
diversified character, richness in original matter, and accuracy 
and copiousness of description, speak more strongly than could 
be done in mere words of the industry, scientific attaiuments, 
powers of observation, and truthfulness of their author.* 

But, in this slight sketch of his contributions to periodical 
works of science, I have been anticipating the course of his life r 
and must return to a period but shortly subsequent to the com- 
mencement of these labours. 

He had at that time considerably widened his social circle, had 
formed intimacies with many persons of distinction in science 
and in the common walks of life, had become favourably known in 
the community at large, and was rapidly extending his business 
as a practitiouer of medicine. Only one thing was wanting to 
give permanence to his well-being, by affording a point towards 
which his thoughts and energies might ever tend, as the centre 
of his life. This want was supplied by his marriage, October 
23, 1827, with Rebecca, daughter of Robert and Elizabeth Pear- 
sail, highly respected members of the Society of Friends, origin- 
ally of 2sew York, but at that time residing in Philadelphia. 
This connection was, in all respects, a most happy one for Dr. 
Morton. He secured by it not only a devoted companion, who 
could appreciate, if not participate in, his pursuits, and lighten 
by sharing with him the burdens of life, but the blessing, also, 
of a loved and loving family, which gave unwearied exercise to 
his affections, and sustained a never-ceasing strain of grateful 
emotion, that mingled sweetly with the toils, anxieties, and suc- 

*For a catalogue of these and of the other works of Dr. Morton, the 
reader is referred to the Appendix of the Memoir prepared by Dr. Meigs. 



A MEMOIR OF DR. SAMUEL GEORGE MORTON. 461 

cesses of his professional career, and gave an otherwise unattain- 
able charm to his intervals of leisure. 

It is reasonable to suppose that his professional business was 
increased by his marriage. That he possessed, in some measure, 
the confidence of the public as a practitioner, is shown by his 
appointment, in the year 1829, as one of the physicians to the 
Philadelphia Almshouse Hospital. Here he enjoyed ample 
opportunities for pathological investigations, of which he availed 
himself extensively, especially in relation to diseases of the chest, 
towards which his attention had been particularly directed by 
.attendance on the clinical instructions of Laennec, during his 
stay in Paris. The fruit of these investigations will be seen in 
a work which will be more particularly noticed directly. 

In the year 1830, Dr. Morton added to his other duties those 
of a medical teacher. A brief notice of the association with 
which he was connected may not be amiss ; as it was one of the 
first of those organizations, now familiar to the profession in 
Philadelphia, in which a number of physicians unite, in order 
to extend to their private pupils advantages, which, separately, 
it would be impossible for them to bestow. It is quite unneces- 
sary that I should speak of the benefits which have accrued 
from this plan of instruction to the profession in this city. 
Most of those who now hear me have, I presume, been taught 
under that system, and some are at this moment teachers. You 
can, therefore, appreciate its advantages ; but it is only the older 
among you who can do so fully, as it is only they who can 
compare it with the irregular and inefficient plan of private 
tuition that preceded it. Another incidental advantage has been 
the training of a body of lecturers, from among whom the in- 
corporated schools have been able to fill their vacant professorial 
chairs with tried and efficient men, and thus to sustain, amidst 
great competition, the old pre-eminence of Philadelphia as the 
seat of medical instruction. 



462 A MEMOIR OF DR. SAMUEL GEORGE MORTON. 

The late Dr. Joseph Parrish, from the increasing number of 
his office pupils, was induced to engage the services of a number 
of young medical men, to aid him, by lectures and examinations 
on the different branches of medicine, in the education of his 
class. This arrangement was in efficient operation for several 
years, but was at length superseded by another, in which all 
the teachers were placed on a footing of perfect equality ; the 
private pupils of each one of them being received on the same 
terms, and those of other private teachers, not belonging to the 
association, being admitted on moderate and specified conditions. 
It was in January, 1830, that this little school was formed. In. 
accordance with the simple tastes of its most prominent member, 
it took the modest name of " Philadelphia Association for Medi- 
cal Instruction," a title which still survives in a highly respect- 
able existing summer school, though the original association has 
long been dissolved. The first lecturers were the late Di\ 
Joseph Parrish on the practice of medicine, Dr. Franklin Bache 
on chemistry, Dr. John Rhea Barton on surgery, Dr. Morton on 
anatomy, and myself on materia medica. About the same time, 
another combination of the same character was formed, denomi- 
nated, I believe, the " School of Medicine," in which Dr. C. D. 
Meigs taught midwifery. By an arrangement, mutually advan- 
tageous, the services of Drs. Bache and Meigs were inter- 
changed; the pupils of the "Association" attending the lectures 
of the latter on midwifery, and those of the " School of Medicine" 
the chemical instructions of the former. Dr. Morton continued 
to deliver annual courses on anatomy in this association for five- 
or six years, when it was dissolved. His instructions were 
characterized by simplicity and clearness, without any attempt 
at display, and, so far as I have known, gave entire satisfaction 
both to his associates and pupils. 

On the 28th of November, 1831, he was chosen Correspond- 
ing Secretary of the Academy of Natural Sciences, and was 



A MEMOIR OF DR. SAMUEL GEORGE MORTON. 463 

thus brought into official communication with many scientific 
men in Europe and America. / 

Reference was a short time since made to a work, based 
mainly upon his pathological investigations in the Almshouse 
Hospital. It was denominated " Illustrations of Pulmonary 
Consumption," was printed in the early part of 1834, and con- 
tributed no little to the increase of his reputation as a practi- 
tioner. The work is an octavo of about 180 pages, treats of 
phthisis in all its relations, and is illustrated by several painted 
plates, executed with skill and accuracy. At that time little 
was known in this country of the admirable work of Louis on 
Consumption ; and the book of Dr. Morton no doubt contributed 
to the spread of sound views, both pathological and therapeuti- 
cal, upon the subject. He particularly insists on the efficacy of 
exercise in the open air in the treatment of the disease, follow- 
ing in this respect in the footsteps of his preceptor, Dr. Parrish, 
to whose memory great honour is due, for his successful efforts 
to revolutionize the previously vague and often destructive 
therapeutics in phthisis. 

Yery soon after the publication of this work, in the year 
1834, Dr. Morton had an opportunity of making a voyage to 
the West Indies, as the companion and medical attendant of a 
wealthy invalid. On this occasion he visited several of the 
islands, making observations as he travelled in relation to their 
geological structure, and at the same time investigating, with 
peculiar attention, the influence of their climate upon phthisis, 
and their relative fitness as places of resort for consumptive 
patients from colder regions. 

Some time after his return from the West Indies, he edited an 
edition of Mackintosh's Principles of Pathology and Practice 
of Physic, adding explanatory notes, and making numerous 
additions to supply deficiencies in the original work. A second 
American edition was published in 183?, under his supervision. 



464 A MEMOIR OF DR. SAMUEL GEORGE MORTON. 

When it was that he began to turn his attention especially to 
ethnological studies I am unable to say ; but it is probable that 
the idea of making a collection of human crania, especially those 
of the aboriginal races of this continent, both ancient and 
modern, originated soon after he entered into practice, if not 
even previously ; and, among the earliest recollections of my 
visits to his office, is that of the skulls he had collected. It is 
well known to you that much of his time and thoughts, and 
not a little of his money, were expended in extending and com- 
pleting this collection, in which he was also materially assisted 
by his own private friends, and the friends of science in gen- 
eral, who were glad to contribute their aid to so interesting an 
object. The cabinet thus commenced was gradually augmented, 
embracing the crania of the lower animals as well as those of 
man, until at length it grew to a magnitude almost beyond pre- 
cedent ; and, at this moment, it forms one of the greatest boasts 
of our country in relation to natural science. It is ardently to 
be hoped that means may be found to secure its retention here, 
and that it may ever continue to enrich the varied collections of 
our Academy, among which it has been deposited.* 

The possession of such materials naturally led to the wish to 
give diffusion and permanence to the knowledge which they laid 
open. Hence originated Dr. Morton's great work on American 
Crania, in which accurate pictorial representations are given of 

* I have been informed, on the very best authority, that, independ- 
ently of all the assistance in making this collection afforded by others, 
it cost Dr. Morton somewhere between ten thousand and fifteen thousand 
dollars. Through the contributions of a number of gentlemen, inter- 
ested in the scientific reputation of our city, this collection was secured 
for the Academy, and now forms a portion of its invaluable museum. 
It is due to the heirs of Dr. Morton to state, that the sum received 
for the collection bore but a small proportion to that expended in its 
formation. 



A MEMOIR OF DR. SAMUEL GEORGE MORTON. 465 

a great number of the skulls of the aborigines of this conti- 
nent, with descriptions, historical notices, and various scien- 
tific observations ; all preceded by an essay on the varieties of 
the human species, calculated to give consistency to the neces- 
sarily desultory statements which follow. The preparation of 
this work cost the author a vast deal of labour, and an amount 
of pecuniary expenditure which has never been repaid, unless 
by the reputation which it gained for him, and the consciousness 
of having erected a monument to science, honourable to his 
country, and likely to remain as a durable memorial of his own 
zeal, industry, and scientific attainment. It was published in 
1839. It is due to Dr. W. S. W. Ruschenberger to state, that 
the work was inscribed to him by Dr. Morton, with the acknowl- 
edgment that some of its most valuable materials were derived 
from his researches in Peru. 

In September, 1839, Dr. Morton was elected Professor of An- 
atomy in the Pennsylvania Medical College, the duties of which 
office he performed until November, 1843, when he resigned. 
In that institution he was associated with the late Dr. George 
McClellan, who may be looked on as its founder, and for whom 
he formed a friendship which ended only with life. 

On the 26th of Mav, 1840, he was elected one of the Yice- 
Presidents of the Academy of Natural Sciences, in which ca- 
pacity he very often presided at its meetings, in the absence of 
the President. 

He was engaged about this time ,in preparing a highly in- 
teresting memoir on the subject of Egyptian Ethnography, based 
mainly upon the observation and comparison of numerous crania, 
in the collection of which be was much aided by Mr. George R. 
Gliddon, whose residence in Egypt gave him opportunities, which 
an extraordinary zeal, in all that concerns the ancient inhabit- 
ants of that region, urged him to employ to the best possible 
advantage. This memoir was embraced in several communica- 

30 



466 A MEMOIR OF DR. SAMUEL GEORGE MORTON. 

tions to the American Philosophical Society, in the years 1842 
and 1843, which were published in the Transactions of that 
Society (Yol. ix., New Series, p. 93, a.d. 1844), and also in a 
separate form, under the title of "Crania Egyptiaca, or Observa- 
tions on Egyptian Ethnography," with handsomely executed 
drawings of numerous skulls, derived from the pyramid of Sac- 
cara, the necropolis of Memphis, the catacombs of Thebes, and 
other depositories of the ancient dead in that region of tombs. 

In January, 1845, Dr. Morton was elected a Fellow of this 
College. That we did not more frequently see him among us, 
was probably owing to the unfortunate coincidence, at that time 
existing, of the meetings of the College and Academy, which 
would have rendered necessary a neglect of his official duties in 
the latter institution, had he attended at the sittings of the- 
former. It may be proper here to mention, though not in strict 
chronological order, that, by the appointment of the College, he 
prepared a brief biographical sketch of Dr. George McClellan, 
which was read in September, 1849, and published in the Trans- 
actions of that date. 

In the years 1846 and 1847, he prepared essays "On the Eth- 
nography and Archaeology of the American Aborigines," and 
"On the Hybridity of Animals and Plants in Reference to the 
Unity of the Human Species," which were read before the Aca- 
demy, and afterwards published in the American Journal of 
Science and Arts (III., 2d ser., a.d. 1847). In these papers he 
advanced opinions upon the origin of the human family, which 
led to an unfortunate controversy, that, with his delicacy of 
feeling, could not but have in some measure disturbed the tran- 
quillity of the latter years of his life. It is due to Dr. Morton to 
say that he did not consider the views, advocated by himself, as 
conflicting with the testimony of Scripture, or in any degree 
tending to invalidate the truths of revealed religion. 

During the year 1848, much of his time was devoted to the pre- 



A MEMOIR OF DR. SAMUEL GEORGE MORTON. 46T 

paration of an elementary work on "Human Anatomy, Special, 
General, and Microscopic" illustrated by a great number of 
figures, and aiming to be an exposition of the science in its 
present improved state. Among his inducements to this work, 
not the least, as he states in the preface, was the desire to be 
enrolled among the expositors of a science that had occupied 
many of the best years of his life. Though laying no claim to 
originality in its facts or illustrations, the treatise cost him a 
great deal of labour, not only in the arrangement of the matter, 
the care of the engravings, and the superintendence of the press, 
but also in the verification, by microscopic observation, of the 
accuracy of the pictorial representations of minute structure 
in which it abounds. It was issued from the press early in 
1849 ; but, even before its publication, he had begun to feel the 
effects upon his health, never robust, of the toilsome task he had 
undertaken, in addition to professional and official engagements, 
which alone would have been sufficient for the wholesome em- 
ployment of his time and energies. 

Scarcely had his last duties in connection with this w 7 ork on 
Anatomy been performed, when in December, 1848, he was at- 
tacked with a severe pleurisy and pericarditis, which brought 
him into the most imminent danger of life, and from the effects 
of which he never fully recovered ; for though, after a long con- 
finement, he was enabled to go about, and even to resume his 
professional duties, he was left with great and permanent de- 
rangement of his thoracic organs. 

The very obvious depression of his left shoulder, and the 
falling in of the corresponding side of the chest evinced, at a 
glance, that with the absorption of the pleuritic effusion the 
lung had not expanded ; and the loud murmur, obvious upon 
auscultation over the heart, proved to his professional friends 
that this organ had not escaped without serious injury. Not- 
withstanding, however, the amount of local derangement, his 



468 A MEMOIR OF DR. SAMUEL GEORGE MORTON. 

system rallied ; and, after an absence of some weeks from the 
city, he returned so much improved in health and strength, that 
he felt himself authorized to resume his active professional 
avocations, and general previous course of life, though with 
some abatement of his labours in the fields of original investi- 
gation and of authorship. 

Could his sense of duty, at this period, and the disposition to 
strong mental activity, which had probably become by habit 
almost a necessity of his nature, have permitted him to with- 
draw from all vigorous exertion, aud to devote his time for the 
future rather to quiet enjoyment than to laborious effort, it is 
not impossible that his life might have been considerably pro- 
longed. Such was the advice of some of his medical friends ; 
but stronger iufluences impelled him to exertion ; and, like most 
men who feel themselves irresistibly drawn into a certain course 
of action, he succeeded in reconciling this course not only to his 
general sense of duty, but even to his views of what was re- 
quired under the particular circumstances of his health. He was 
convinced that, by active bodily exertion, he should be most 
likely to bring his defective lung back again to the performance 
of its function ; and certainly, for a time, his improving appear- 
ance and increasing strength under exercise seemed to justify the 
system he had adopted. 

Before adverting to the closing scene, let us stop, for a very 
few minutes, to take a view of his character and position at this 
period, which, if the consideration of his health be omitted, was 
the most prosperous of his life. 

His election to the presidency of the Academy of Natural 
Sciences, which took place December 25, 1849, had given him an 
official position than which he could not expect to gain one more 
honourable, and than which society in this country have few 
more honourable to bestow. Of an amiable and benevolent 
temper, indisposed to give offence, or to wound the sensibilities 



A MEMOIR OF DR. SAMUEL GEORGE MORTON. 469 

of others, be had conciliated general good-will; while his affec- 
tionate disposition, his deep interest in those to whom he was 
attached, and his readiness to serve, secured him warm friends, 
especially in the circle of his patients, who in general had much 
regard for him personally, as well as great trust in his skill. 
Powers of quick and accurate observation, and a sound cautious 
judgment were perhaps his most striking intellectual character- 
istics, and naturally led him into those departments of science 
where they could be most efficiently exercised. 

By strict attention to his professional duties, even in the midst 
of his scientific researches, by an affectionate interest in his 
patients, inspiring similar sentiments on their part, and by a 
system of cautious but successful therapeutics, he gained a large, 
and for Philadelphia, a lucrative practice, which, with some in- 
come derived by inheritance from an uncle in Ireland, enabled him 
to live handsomely, and not only to entertain his scientific friends 
and associates on frequent occasions at his house, but also to 
extend hospitalities to strangers, whom his reputation attracted 
towards him upon their visits to our city. His friends will not 
soon forget the weekly soirees, at which they enjoyed the pleas- 
ure of combined social and scientific intercourse, and had the 
frequent opportunity of meeting strangers, distinguished in the 
various departments of learning and philosophy. 

His extensive professional relations, and his reputation both 
as a practitioner and teacher of medicine, attracted to his office 
many young men disposed to enter into the profession ; and he 
usually had under his charge, towards the close of his life, a 
considerable number of private pupils, to whom he devoted much 
time, and his most conscientious endeavours to qualify them to 
be good physicians. 

Numerous learned and scientific associations in different parts 
of America and Europe had enrolled him among their members; 
and perhaps few men in this country had a more extensive cor- 



470 A MEMOIR OP DR. SAMUEL GEORGE MORTON. 

respondence with distinguished individuals abroad.* To be 
praised by the praised is certainly a great honour ; and this Dr. 
Morton was happy enough to have won in no stinted measure. 

With these meritorious qualities, these well-earned distinc- 
tions, and these diversified sources of comfort and enjoyment, 
with the crowning pleasures, moreover, of domestic confidence 
and affection, and bright hopes for arising family, our late friend 
and fellow-member may be considered, at this period of his life, 
as one of the most happy of men in all his exterior relations. 
The only drawback was the uncertain state of his health. 

From early manhood he had been of delicate constitution. 
Two attacks of severe hagmatemesis had on different occasions 
threatened his life ; and for a long time he suffered much with 
excruciating attacks of sick headache, which most painfully in- 
terrupted his scientific and professional avocations, and not un- 
frequently confined him for a time to his bed. For many years 
of his earlier life, his pale complexion and spare form indicated 
habitually feeble health; but at a more advanced period he 
seemed to have greatly improved in this respect, exhibiting a 
more healthful colour and more robustness of frame; and, but 
for the terrible attack which prostrated him in the winter of 
1848-49, there seemed to be no reason why he should not live 
to a good old age. But the fiat had gone forth ; and, though a 
respite was granted, it was destined to be short. 

A painful incident, which happened about this time, may pos- 
sibly have had some effect in aggravating the morbid tendencies, 
already unhappily strong. 1 refer to the illness and speedy 
death, in May, 1850, of an affectionate, dearly loved, and highly 
promising son, to whose future he was looking forward with 
much, and apparently well-founded, confidence. 

* For a list of the societies of which he was a member, see the Appen- 
dix to Dr. Meigs's Memoir. 



A MEMOIR OP DR SAMUEL GEORGE MORTON. 471 

Perhaps at no time was Dr. Morton more busily occupied in 
practical duties than during the year or two which preceded his 
death. He was indefatigable in attendance upon his numerous 
patients, devoted no little time to the instruction of his private 
pupils, and never voluntarily omitted the performance of his 
academic functions. In the midst of this career of usefulness, 
he was seized with an illness, which, commencing on the 10th 
of May with a moderate headache, became more severe on the 
following day, and, though afterwards relaxing so much as to 
give hopes of a return to his ordinary health, ended in an attack 
of stupor and paralysis, which proved fatal on the 15th, the very 
day upon which, one year previously, he had witnessed the death 
of his son. 

Dr. Morton was considerably above the medium height, of a 
large frame, though somewhat stooping, with a fine oval face, 
prominent features, bluish-gray eyes, light hair, and a very fair 
complexion. His countenance usually wore a serious and thought- 
ful expression, but was often pleasingly lighted up with smiles, 
during the relaxation of social and friendly intercourse. His 
manner was composed and quiet, but always courteous, and his 
whole deportment that of a refined and cultivated gentleman. 

He left behind him a widow and seven children, five sons and 
two daughters, several of whom have advanced to adult age, and 
are engaged in active life. In the remembrance of the virtues, 
the attainments, the fruitful labours, and the well-earned repu- 
tation of the husband and father, they have a legacy far more 
precious than the gifts of fortune ; an inheritance which no mis- 
chances of this world can impair, and which will be handed down 
as a priceless heirloom to their latest posterity. 



INDEX. 



PAGE 

Abuses of the Materia Mediea 128 

Address at the Medical Commence- 
ment in April, 1841 365 

Address at the Medical Commence- 
ment in March, 1836 343 

AddYess at the Medical Commence- 
ment in March, 1856 384 

Addresses, Pharmaceutical 1 

Addresses to Medical Graduates... 341 
Address to the Graduates of the 
Philadelphia College of Phar- 
macy 31 

Addresses to the Medical Gradu- 
ates of the University of Penn- 
sylvania 339 

Address to the Members of the 
Philadelphia College of Phar- 
macy 3 

Allopathy and Allopathists, impro- 
priety of the names 262 

American Colleges of Pharmacy.... 1Q2 
American Journals of Pharmacy... 97 
Amphitheatre of the Hospitals at 

Paris 320 

Animal Magnetism, as a Remedial 

Agent 166 

Apothecaries in England 268, 294 

Apothecary, Standard of Attain- 
ment and Character of the 5 

Arabian Writers on Materia Mediea 64 
Association for Medical Instruc- 
tion, Philadelphia 418,462 

Authors on Ma eria Mediea, Ame- 
rican 87, 96 

Authors on Ma 1 eria Mediea, mod- 
ern 76 



PAGE 

Bache, Franklin, M.D... 31, 95, 312, 462 
Bachelor of Medicine, Degree of, in 

the University of Pennsylvania 357 
Barton, Benjamin Smith, M.D... 88, 200 

Barton, John Rhea, M.D 462 

Barton, Wm. P. C, M.D 91 

Bartram, John 87 

Basil Valentine 66 

Beck, John B., M.D 96 

Beck, Lewis C, M.D 96 

Bell, John, M.D 96 

Biddle, John B., M.D 96 

Bigelow, Jacob, M.D 91 

Biographical Memoirs 399 

Bond, Dr. Thomas 348 

Broussais 114, 269 

Brown, Dr 114 

Carson, Joseph, M.D 96, 97, 341 

Catesby 88 

Celsus, Writings of 60 

Chapman, Nathaniel, M.D., sketch 

of the character and life of. 215 

Chapman's Therapeutics and Ma- 
teria Mediea 94 

Character and Objects of the Medi- 
cal Profession 238 

Chemists, Sect of the 66 

Choice of Medicines 172 

Christison, Dr 292 

Clayton, Dr. John 87 

Clinical Instruction, Importance of 232 

Clinical Instruction in Europe 318 

Colden, Dr. Cadwallader 87 

College of Physicians of Philadel- 
phia (note) 29 

(473) 



474 



INDEX. 



Colleges of Pharmacy, American... 102 
Continent of Europe, Medical Pro- 
fession in the 311 

Coxe, John Redman, M.D 94 

Death, in what manner to be viewed 395 
Degree in Pharmacy, Importance 

of establishing 15 

Demonstrative Teaching, Import- 
ance of 232 

Dewees, Dr. Wm. P 354 

Dioscorides, Writings of. 61 

Dogmatists, Sect of the 58 

Dorsey, John Syng, M.D 351 

Dunglison, Robley, M.D 96 

Eberle's Materia Medica and The- 
rapeutics 95 

Efficiency of Medicine 275 

Ellis, Benjamin, M.D 31. 96 

Elmer, Jonathan. M.D 348 

Elmer, William, M.D 348 

Emotions as Remedies 154 

Empiricism 143,193, 3S0 

Empirics, Sect of the 5S 

European Continent, Medical Pro- 
fession on the 311 

European Schools of Medicine 315 

European Writers on Materia Med- 
ica, modern 75 

Examinations, Importance of, in 

Medical Instruction 230 

Examinations in the Medical 

Schools of Europe 321 

Faith as a Remedy 160 

False Theory, Influence of, in the 

Use of Medicines 135 

Fashion, Influence of, in the Use 

of Medicines 133 

Feelings as Remedies 154 

Frost, Henry R., M.D 96 

Galenists, Sect of the 66 

Galen, Writings of 62 

General Practitioners in England.. 294 
Gerhard, Wm. W., M.D 438 



PAGE 

Germany, Medical Schools of. 316 

Graduates, Annual Number of, in 
the Medical Department of the 
University of Pennsylvania 356, 357 
Graduates of the Philadelphia Col- 
lege of Pharmacy, Address to the 31 
Great Britain, Medical Profession 

in 285 

Griffith. R. Eglesfeld, M.D 96, 97 

Griffitts, Samuel Powell, M.D 407 

Hare, Robert, M.D 187 

Harlan, Richard, M.D 456 

Harrison, John P., M.D 96 

Hippocrates, Writings of 57 

History of Materia Medica 55 

History of Materia Medica in the 

United States 7S 

History of the Medical Department 

of the University of Pennsylvania 343 

Hodge, H. L., M.D 216 

Homoeopathy and Homceopathists 

136, 261, 272 

Hooker, Worthington, M.D 97 

Hope as a Remedy 157 

Horner, Wm. E., M.D 216, 333 

Hospitals as Schools of Medicine in 

Europe 302, 318 

Hospitals in Europe 325 

Imagination as a Therapeutic Agent 163 

Imperfection of Medicine 266 

Imperial Medico-Chirurgical Acad- 
emy of St. Petersburg 330 

Importance of Materia Medica 109 

Importance of the Practice of Medi- 
cine 221 

Intellectual Faculties, Remedial 
Influence of the 162 

Introductory Lectures on Materia 
Medica 53 

Introductory Lectures to the Course 
on the Theory and Practice of 
Medicine 197 

Ireland, Medical Instruction and 
Profession in 306 

Isaac of Holland 66 



INDEX. 



475 



PAGE 

Jackson, Samuel, M.D 12, 21(5, 333 

Journals of Pharmacy. American... 97 
Journey in Europe 311 

Kalm SS 

Kuhn, Dr. Adam 348 

Lectures, Advantages of 125 

Lectures Introductory to the 
Courses on Materia Medica and 
Pharmacy in the University of 
Pennsylvania 51 

Lectures Introductory to the Course 
on the Theory and Practice of 
Medicine 195 

Lectures on the Theory and Prac- 
tice of Medicine, plan of 212 

Lee, Charles A., M.D 96 

McClellan, George, M.D 465 

Maryland College of Pharmacy 98 

Materia Medica, Abuses of the 128 

Materia Medica, American Writers 

on 88, 96 

Materia Medica, History of 55 

Materia Medica, History of, in the 

United States 78 

Materia Medica, Importance of 109 

Materia Medica, modern European 

Writers on 75 

Medical Department of the Uni- 
versity of Pennsylvania, Histor} 7 

of the 343 

Medical Education in Russia 330 

Medical Education on the Conti- 
nent of Europe 314 

Medical Instruction, Philadelphia 

Association for 418, 462 

Medical Profession, Character and 

Objects of the 238 

Medical Profession in Great Bri- 
tain, Lecture on the 285 

Medical Profession on the Conti- 
nent of Europe, Lecture on the... 311 

Medical Schools in England 302 

Medicines of American Origin 80 

Meigs, Charles D., M.D 451, 462 



PAOE 

Memoir of Dr. Joseph Parrish 401 

Memoir of Dr. Samuel George 

Morton 451 

Memoirs, Biographical 399 

Mental Agency in the Treatment 

of Disease 150 

Mercenary Spirit in the Medical 

Profession, effects of 242 

Mesmerism as a Remedial Agent... 170 

Michaux the Elder 90 

Michaux the Younger 90 

Mitchell, John K., M.D 169, 216 

Mitchell, Thos. D., M.D 96 

Moral Remedies 154 

Morgan, Dr. John 347 

Morton, Samuel George, M.D., Me- 
moir of 451 

New York College of Pharmacy.... 102 
Novelty, Influence of, in the Choice 

of Medicines 183 

Novelty, Influence of, in the Use 

of Medicines 133 

Otto, John C., M.D. (note) 445 

Paine, Martyn, M.D 96 

Paracelsus 66 

Parrish, Dr. Joseph, Memoir of..... 401 

Parrish, Edward 97 

Passions as Remedies 154 

Pereira, Dr 292 

Pharmaceutical Addresses 1 

Pharmacopoeia of the Medical So- 
ciety of Massachusetts 100 

Pharmacopoeia of the United States 

28, 100, 175 

Pharmacopoeias, British 100 

Pharmacy, State of the Profession 

of 34 

Philadelphia as a Seat of Medical 

Instruction 358 

Philadelphia Association for Medi- 
cal Instruction 418, 462 

Philadelphia College of Pharmacy 3, 11 
Physicians and Surgeons of the 

Continent of Europe 326 



476 



INDEX. 



PAGE 

Physicians in England 2S8 

Physick, Dr., Letter from 354 

Phvsick. Dr. Philip Syng, Notice of 352 

Pliny, Natural History of 62 

Polished Manner, Importance of, to 

the Physician 254 

Politeness, Conventional 255 

Politeness, Native 256 

Poplar Worm 409 

Practice of Medicine, Importance 

of 221 

Practice of Medicine, not a Particu- 
lar System 260 

Practice of Medicine, Scope of 260 

Procter, Prof. Wm., Jr 97 

Professional Secrecy 25S 

Professional Spirit, Importance of 370 
Profession of Medicine, Influence 

of, on its Members 376 

Professions of Medicine and Phar- 
macy, Separation of the 20,36 

Pursh, Frederick 90 

Quackery 143,193, 380 

Qualifications of a Physician 372 

Requisites in the Study of Medi- 
cine 220 

Ruschenberger, W. S. W., M.D 465 

Rush, Dr. Benjamin 114, 269, 34S 

Prussia, Medical Profession and 
Schools in 329 

Schools of Medicine, European 315 

Scope of the Practice of Medicine.. 260 j 
Scotland, Medical Instruction and 

Profession in 307 

Scribonius Largus, Writings of 61 

Secrecy, Professional 25S 

Secret Medicines 191 

Sessions, Length of, in Medical 

Schools 211 

Shippen, Dr. William 347 

Shoepf, Dr S8 

Signatures, Doctrine of 69 



Skepticism in Medicine 274 

Smith, Daniel B. (note) 38 

Somnambulism 167 

Sordid Views in a Physician, Tend- 
encies of. 242 

Spontaneous Curability of Diseases 271 

Stille, Alfred, M.D 97 

Studies after Graduation 367 

Study as Distinguished from Read- 
ing 225 

Study of Medicine, Requisites in the 220 
Study of the Theory and Practice 

of Medicine 228 

Surgeons in England 292 

Term of Study in the Schools, Ex- 
tent of the 211 

Thatcher, James, M.D 94 

Theory and Practice of Medicine, 

Extent of, as a Branch of Study.. 202 
Theory and Practice of Medicine, 

Importance of 203 

Theory and Practice of Medicine, 

Introductory Lectures to 197 

Theory in Medicine 265 

Therapeutics and Pharmacology, 

Treatise on, by the Author 97 

Tully, William, M.D 93, 97 

Typhous Epidemic of 1812-13 412 

United States Dispensatory 95 

University of Pennsylvania, His- 
tory of the Medical Department 
of the 343 



Van Helmont 

Von Colin, John. 



66 
88 



Wistar, Dr. Caspar 407, 426, 428 

Wistar, Dr. Caspar, Notice of 351 

Writers on Materia Medica, Ame- 
rican 88, 96 

Writers on Materia Medica, modern 75 
Wylie, Sir James, Sketch of the 
Life of. 332 



